Name: Last, First, Middle
Date of Birth | Home Telephone
Home Address
What is your affiliation with the US Army?
Service Member DOD Civilian Employee Dependent Other (explain below)
Name of College you plan to attend:
Current Counselor or Faculty Advisor | Telephone Number
Major or Field of Concentration Type of program: Associate __ Baccalaureate __
Parent/Guardian’s Name | AQM Member (Yes/No)
Member # _____________
Parent/Guardian’s Address (If different than above)
Parent/Guardian’s Home Telephone Number (If different from above)
YOUR APPLICATION PACKAGE MUST INCLUDE THE FOLLOWING:
_____ High School or College transcript.
_____ 1-2 letters of recommendation.
____ A 1,000 -1,500 word leadership essay.
_____ This form completed and signed.
_____ Personal History Sheet.
Return to: Association of Quartermasters, Attn: Scholarship Committee,
PO Box 5038, Fort Lee, VA 23801
Application Must Be Postmarked No Later Than 15 April 2008
.
Your signature below constitutes permission for the Scholarship Committee to contact the counselor or faculty advisor named above, for additional information, if necessary.
Applicant’s Signature | Date