LEXINGTON VOLUNTEER FIRE DEPARTMENT Please type or print your answers. Applicant Name: Address:

City/State:

Zip:

Phone Number:

Date of Birth:

Name of address of parent(s) or legal guardian(s): Name: Address:

City/State:

Zip:

Phone Number:

Grade Point Average (GPA):

(on a 4.0 scale)

I will be attending the following school in the Fall: List any college, college courses/classes you have attended/taken:

What specialty/major do you plan as you continue your education:

Proof of acceptance or current student enrollment from the above school is required prior to receipt of funds.

Please attach a 500 word essay on “The Importance of Volunteers in a Community”

Deadline for Scholarship is May 17, 2016 by 3:00pm. All scholarships must be turned in to the HS Counselor’s Office.