The Hayden Scholarship Foundation
Application
All items must be completed. Please print in ink or type. Return completed application to:
The Hayden Scholarship Foundation 9807 Highridge Las Vegas, NV 89134
Deadline for Fall, August l5th; Spring, January 15th!
Name_________________________________________________________________________________
LAST
FIRST
MIDDLE
MAIDEN
Social Security Number______________________________ Date of Birth_________________________
E-Mail Address____________________________________________ Sex: ______Male ______Female
Permanent Address______________________________________________________________________
STREET or P.O. BOX
____________________________________________________________________________________________________
CITY
STATE
ZIP
____________________________________________________________________________________________________
COUNTY
TELEPHONE NUMBER
Local Address__________________________________________________________________________
STREET or P.O. BOX
____________________________________________________________________________________________________
CITY
STATE
ZIP
TELEPHONE NUMBER
Enrollment Status: ___New freshman
___Transfer
___Re-Entry
___Currently Enrolled
Classification:
___Freshman
___Sophomore
___Junior
___Senior
This application for scholarships is for the _____________ academic school year.
SCORES:
ACT_______
SAT_______
High School GPA_______ College GPA (if applicable)_______
Intended College ______________________________________Intended Major __________________
High School Graduated From:___________________________________ Date_____________________
Please note The Hayden Scholarship sends funds directly to the University or
College to be applied to tuition expenses.
Please do not forget to complete the second page of the application!!!
List below any honors that you have received. (Include academic, extracurricular, athletic, community
service, etc.)
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List Extracurricular Activities (Include participation in community activities as well).
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If there is any further information that you feel would be helpful to The Hayden Scholarship in considering
you for funds please use the following space to explain.
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I certify that the information submitted is true and complete to the best of my knowledge.
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Signature of Applicant
Date