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Preliminary Scholarship Application Form
Name of Applicant______________________ Gender_______ Date of Birth_____________ Current Address______________________ Date of Application__________ _______________________________ E-mail Address___________________________ Telephone______________________________ Permanent Address_______________________________________________________________ Educational Background (include college and any post-graduate experiences) ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________
Reason(s) for Scholarship Request __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ Amount of Request_____________________________________________ If your preliminary scholarship request complies with Foundation guidelines, you will receive additional information and a secondary questionnaire. Mail application to: Wendy Kohler Sara's Wish Scholarship Fund 15 Ash Lane Amherst, MA 01002Preliminary applications are accepted annually from October 1st through January 31st.
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