Name: _________________________________________________________________________
Address: _______________________________________________________________________
City: __________________________ State: _______________ Zip Code: _________________
Phone: _____________________________ SSN: _____________________________________
Email: _________________________________________________________________________
Career Readiness Class # ________________________
Status:
Number of Dependents and Ages: ___________________________________________________
Place of Employment: _____________________________ Position: ______________________
Start Date if Employment: __________________________
Net Adjusted Gross Income for 2006: ________________________________________________
Name of School/College/University: _________________________________________________
Major Area of Study: ________________________ Minor Area (if any) ____________________
Semesters Completed: _______________________ GPA: _______________________________
Please attach a separate sheet answering the following essay questions:
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Please tell us, in one-two paragraphs, what your career goals are and how you fell this scholarship will assist you in reaching your goals.
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Please tell us, in one-two paragraphs, how you feel your education has benefited your life and that of your family.
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Please tell us, in one-two paragraphs, how you feel P.R.O.B.E.’s Career Readiness Classes has benefited your personal growth and development.
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What would you like toe tell us about yourself that you feel is important in our consideration of you for this scholarship?
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Please submit to:
Kathy Verna
815 Cumberland St. #206
Lebanon, PA 17042
