Scholarship Application - Geneva Masonic Lodge 139

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Email *

Email

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Phone *

Age *

Sex *

Do you have an immediate family member (Father, Grandfather, Uncle, or Brother) who is a member IN GOOD STANDING of the Geneva Masonic Lodge #139? *

Yes
No

Current Grade Point Average *

Please Enter Two Character References (Other Than Family Members)

Name *

Phone

Do you have any personal Masonic affiliation (Rainbow for Girls, DeMolay International, or other)? *

Yes
No

Describe any Work Experience, Community Service, Leadership Experience and/or Extra-Curricular Activities (School or Community): *

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Identify a personal tragedy in your life that you had to overcome and explain your resolution. *

What are your future goals and if you win this award, how would you apply it to your future goals? *

What do you see as your strengths? *

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In 250 words or more, please explain how the core tenets of Freemasonry—"Brotherly Love, Relief, and Truth” resonate with your personal values and beliefs? Explain how these principles may have influenced your life personally and provide any relevant examples. *

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Applicant's Signature *

Clear Signature

Date *

Scholarship Program

Online Scholarship Application Form

Please Enter Two Character References (Other Than Family Members)

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