Tuition Assistance Form

Knights of Columbus

Bishop William R. Johnson Council, #9487

Tuition Assistance Program Application

Requirements:

1. Be an immediate family member of an active or deceased Council #9487 Brother Knight of Columbus.

2. Be enrolled full time in a Catholic School, primary, high school, college or university

3. Attests that the information provided below, to the best of their knowledge, is accurate.

4. Agrees that the funds provided will be directly used to support the students Catholic Education.

Student Name: Age:

Street Address:

City: State: Zip Code:

Phone (day): Phone (night):

Knight of Columbus Name: Deceased:

Membership Number:

School Attending:

I have applied for additional forms of financial assistance:

Why does the student need this assistance?

Student Signature:

Knight of Columbus Signature:

Instructions:

1. Complete an Application form for each student, attach copy of current membership card of family member if possible, the Knight must sign the application if not deceased..
2. Student writes 1-2 page essay on “The Benefits of a Catholic School Education”
3. Send Application and Essay to: (EMAIL: edmalk@cox.net, the Knight must confirm by telephone)	KC Scholarship Program Edward G. Malk, PGK 24901 Avenida Libre Lake Forest, CA 92630
4. Notification of Awards will be made during June

If you have questions, please contact Ed Malk at (949) 583-1425

Registration Deadline

May 31, 2002

Notifications of Awards will be made on June 6, 2002.