Aaron and Joseph Zarate Scholarship Award
Scholarship Application Form
Applicant’s Full Name________________________________________ High School_______________
Student lives with: parent/s___ legal guardian___ other___
Home address____________________________________________________
City State zip
Home Ph____-__________ Cell Ph___-________ Email_________________
Male___ Female___ GPA___ Please enclose official transcript
Name of community college, university or tech school_______________________________
Address______________________________________________________________________
City State zip phone #
Admitted: Yes___ No___
Subject area/major you plan to study after High School_______________________
Payment of monetary award will be made in the recipients name to the school of their choice and must be used within the first year following graduation. To receive funds, recipient agrees to submit school information and proof of enrollment to address below no later than October 31 of year scholarship is awarded. I understand that if I am awarded this scholarship I may be interviewed and/or must attend award ceremony (date TBA)
Certification and Signature: I certify that all the information is true and complete to the best of my knowledge. All application materials becomes property of Aaron and Joseph Zarate Scholarship. I hereby give my permission for a photo or likeness to be used of me in promotional material.
Parent or Guardian_____________________________________ Date___________
Parent/Guardian signature not required if student is 18+
Student______________________________________________ Date___________
Completed Application and all information must be postmarked
no later than May 05
Zarate Memorial Scholarship 4902 99th St SW Mukilteo WA 98275Page 3 of 3
REVISED 4/2015
