Thank you for your interest in a scholarship from the Benevolent and Protective Order of Elks.Please fill out the form below. It will be submitted to the Scholarship Committee for review. General Information Name (First Middle Last)(required) Address(required) City, State, Zipcode(required) Telephone(required) Email(required) Parents Names(required) How this scholarship will help me(required) Education High School Attending(required) Plans after high school(required) Academic Information Cumulative GPA at end of Junior Year(required) Special Honors/Awards in school Include captain/co-captain, letter winner, class offices, club offices, special awards – outstanding athlete, music awards, science awards and other school recognition awards (local, district, regional, state or national). List all Honors/Awards and Years of Participaton. Special Honors/Awards in community List special recognition received by church, service clubs, and other community youth groups. Participation in school activities Include athletic, interscholastic, clubs, school dramatics, intermural sports, music groups, newspaper, student council, yearbook, etc. Participation in community activities List all activities in which you have participated in church, recreation programs, scouting, and other civic youth programs and community activities. Additional Information Hobbies Final Comments Ready to submit. Please click “Submit”. Your form will be emailed to the Elks Scholarship Committee and stored in a save location. Thank you! I am not a robot Submit
