WESTBURY COUNCIL #1012
High School Scholarship Application Receipt Deadline: April 30
Applicant Information (Please type or print clearly)
Student's Name: ______________________________ Phone # __________________
Address: _______________________________________________________________
Current School:____________________________________
Parish:___________________________________________
How often do you attend Mass a month? ________
High School you will be attending: ___________________________________________
Applicants Signature: ______________________________________________________
Date: ______________________
Parent or Guardian's name (print) ____________________________________________
Parent or Guardian's Signature: ______________________________________________
Requirements: Applicant must be a child or grandchild of a Knight of
Columbus Westbury Council 1012 member who is in good standing. Children
of deceased members who were in good standing at the time of their
demise are also eligible.
Name of Member: ___________________________ _____Parent _____Grandparent
Financial need is not a qualification. This completed Scholarship Application MUST
be accompanied by the following documents, no other documents will be
considered, and no documents will be returned to the applicant:
1. Proof of registration in a Catholic High School for the academic year beginning September
2. A 200-300 word essay, written by the applicant, describing his or her
service activities and why a Catholic education is important to them.
Instructions and applications forms are available at our website:
http://www.kofcl012.org
All completed applications MUST be received by April 30, and should be mailed to:
Chairman, Scholarship Committee
Knights of Columbus Westbury Council #1012
PO Box 163
Westbury, NY 11590