Ron Giguere/Elaine Lemieux

Memorial Scholarship Application

Name: ________________________________________________________  Date: ________________

Address: ____________________________________________________________________________

Age: _______  Date of Birth: ______________________  Telephone: ___________________________

Parent(s) or guardian's names: ___________________________________________________________

Address: ____________________________________________________________________________

Name of School: __________________________________  USBC Membership No.  6618-                         

How long have you been in the USBC program? (Count current season as one year)  _________ years.

Offices held in youth leagues (team captain or officer) and years in each office:

(Count current season as one year)

_____________________________________________________________________________________

Offices held in Youth Leaders: ____________________________________________________________

Bowling honors and awards: ______________________________________________________________

School activities and offices held: __________________________________________________________

Community and civic activities: ___________________________________________________________

Provide a short essay to describe what bowling means to you: ___________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

To my knowledge, the above statements are correct.

__________________________________  ________________________________

Signature of Coach                                        Signature of Applicant