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Town of Waltham, Maine

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College Scholarship Application

Requirements: Resident of Waltham or Eastbrook

Age Limit: No older than 21 years of age before December 31 of the year you are applying in.

Date*

Age*

First name*

Last name*

Mailing Address*

Home Address (If different than Mailing Address)

Phone*

Email*

Name of Parent(s) or Guardian(s)*

Address of Parent(s) or Guardian(s)*

List some of your past school and community activities*

Name of Post-secondary school you are attending*

Mailing Address of of Post-secondary school you are attending*

Cost*

When is the money due*

Attach Most Recent School Transcript

Tell us how you feel this Scholarship will benefit you:*

info@walthammaine.org

1520 Waltham Road

Waltham, ME 04605

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