George & Joan White Howell Environmental Education Scholarship Application Form
Name
First
Middle
Last
Social Security Number #
Permanent Address
Street Address
Address Line 2
City
State
ZIP
Phone
Email
High School
Current High School GPA
Overall ACT Score
ACT Score on Science Portion of Exam
Are you willing to help with research projects at Clay Hill Memorial Forest?
Yes
No
Signature
Date
MM slash DD slash YYYY
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