Liz Murray Scholarship Application - Hood Hargett Breakfast Club

Scholarship Application

To apply please complete the form below. Questions can be directed to Kathy Hixon - 704-602-9509

Nominee*
First Last
Home Phone*
Email*
School*
Grade*
Please enter a number from 8 to 12.
Mother's Work Email
Mother's Phone
Father's Work Email
Father's Phone
Home Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Principal Name*
Principal Phone
Principal Email
Athletic Director Name*
Athletic Director Phone
Athletic Director Email
Grade Point Avg. Weighted*
Grade Point Avg. Unweighted*
SAT and/or ACT Score*
Part II
Please provide two written references (i.e. coach, teacher, community person, etc) and send to Kathy Hixon - email: [email protected] or fax: 704374-9403
Athletic Participation/ Awards*
School Activities*
Community Activities*
College Aspirations/ Plans*
Hood Hargett Breakfast Club – Liz Murray Scholarship Fund, PO Box 30127, Charlotte, NC 28203 Contact: Kathy Hixon Phone: 704.602.9509 Fax: 704.374.9403 Email: [email protected] www.hoodhargettbreakfastclub.com ** Hood Hargett Breakfast Club agrees to keep all information provided by applicant confidential ** Criteria for Scholarship: Must be a senior and must attend a school in the Charlotte Mecklenburg School System
Phone
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