LAOH Scholarship - Application
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Applicant:


Last Name                   First Name                  Middle Name

Signature: _______________________________________________________________________________

Address:

Street:       
City:           State Zip
Telephone:        E-mail address:   

Catholic High School:

School:    Grade:
School address:   
School Phone Number

Family:

Mother/Guardian:   
Address:                  
Father/Guardian:     
Address:                  

Signature[s]:     ______________________________________________________________________

AOH / LAOH Sponsor:

Sponsor Name:   
Relationship to Applicant:    

Note to Sponsor: Please write a paragraph explaining why you are referring this student for a scholarship.


Signature:     __________________________________________________________________________


LAOH/AOH sponsor must be in good standing.
Sponsor status will be verified prior to processing application.

Copies of this application can be found in the 'LAOH Newport section'
of the AOH Division #1 website at
www.aohnewport.org