Applicant Information

First NameLast NameDate of Birth (mm/dd/yy)

Street AddressCityStateZip

PhoneE-mail Address

Chosen Institution of Higher Education/VocationField of Study

Occupation/Professional Goal

Applicant Essay

Please describe in 250 words or less why you believe you qualify for the Memorial Scholarship:

Activities & Service

Please list the scholastic, extracurricular and/or community service activities in which you participated during your high
school, college or military service years:

Work Experience

List any work experience you received during high school, college or military service years (include name of employer(s),
length of employment, nature of work and/or areas of military deployment):

2/47th Veteran Relative

Identify the veteran who served with the 47th Infantry Regiment and the relationship to you (parent, stepparent, uncle,
grandparent, etc.). Include the battalion and approximate dates of service (NOTE: A copy of the veteran's discharge papers
are required and should be mailed to the address provided on the confirmation page):

Veteran Name: FirstLastRank

BattalionDates of Service (mm/yy): StartEndKilled in Action?Yes

Relationship to Applicant:

Statement of Financial Need

Please provide a short statement (100 words or less) of your financial need:

Additional Information

Provide any information you feel might be helpful to the committee as they consider your application:

Applicant Agreement and Digital Signature

By checking the box below and entering my full name in the space provided, I certify that to the best of my knowledge
I meet the eligibility requirements for the Vietnam Veterans of the 2ndBattalion 47th Infantry Regiment 9th Infantry
Division Memorial Scholarship, and that the information I have submitted is true and correct. I understand I must
maintain at least a 2.5 grade point average each semester and comply with the rules and regulations of the college
attended and cooperate fully with its faculty and administration. I agree that if I fail to comply with the terms of this
agreement, I may be liable to refund to the Scholarship Foundation funds paid for the current semester. All Scholarship
Committee determinations regarding recipient selections are at the discretion of the Committee and are final.

Yes, I Agree with the Statement Above

Enter Your Full NameToday's Date (mm/dd/yy)