Form C6

Form C6 should be completed if you are applying for the Joseph E. Chase Scholarship - $1,000 Requirements: You must be a graduating senior of Northwest or North High School, rank in the top one-third of your class and plan to attend an accredited college. Participation in school sponsored organizations suchas marching band, student government, or school sponsered clubs will be considered.
Last Name:*
First Name:*
Middle Initial:
Email Address:*
Please list you community services:
Please list your career goals:
Please list Scouting honors and awards earned (not necessary for this scholarship, but commendable):
Confirmation Code: Enter the code shown in the box before clicking on submit.
	Note: Fields marked by an asterisk (*) are required.