Application — The Norman L. Fuld and Renee G. Fuld Scholarship Trust Fund

Please Complete The Application Below And Submit Or Click Here to Download The Application

After completing the form below, the letters of recommendation and high school and/or college transcripts must be mailed to The Norman L. Fuld and Renee G. Fuld Scholarship Trust Fund, c/o Gary M. Krim, Trustee, 1311 Mamaroneck Avenue, Suite 340, White Plains, NY 10605. Your application will not be considered unless those items are received.

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Telephone/Cell Number

Country

(###)

###

####

Email Address

High School Graduation Date

YYYY

Cumulative Grade Point Average

College/Graduate School That You Attend Or Intend To Attend

Describe Your Major Or Intended Field Of Study

If unknown, typen "Unkown"

1. Describe Any Particular Challenges You Have Overcome In Preparing Yourself To Attend College. If You Have Any Physical Handicap, Please Describe:

If none, type "None"

2. List Your Extracurricular Activities (E.G., Student Government, Sports, Publications, School-Sponsored Community Service Programs, Student-Faculty Committees, Arts, Music, Etc.):

If none, type "None"

3. List Any Public Service And/Or Community Activities You Have Participated In And What You Have Gained From Doing So (E.G., Homeless Services, Environmental Protection, Advocacy Activities, Etc.):

If none, type "None"

4. List Any Awards, Scholarships, Grants, Publications Or Special Recognitions You Have Received:

If none, type "None". For Awards, Scholarships and/or Grants, Include Amount

5. List The Names Of The Two Persons Providing Your Letters Of Recommendation And How They Know You:

These individuals must mail their letters of recommendation directly to the Trust Fund.

6. Estimate Your Expected Cost For Your Education, Including Books and Fees Minus The Other Scholarships, Awards and Grants Listed In Item 4, For the Upcoming Academic Year

7. Provide Any Additional Information You Deem Relevant:

if none, type "None"

I Hereby Certify That All The Information Included Above Is:

True

Untrue

Date Submitted

YYYY

By Clicking Submit You Will Have Been Deemed To Sign This Application.

To Complete Your Application Please Have The Two Letters Of Recommendation And Your High School and/or College Transcript(s) mailed/submitted directly to The Norman L. Fuld and Renee G. Fuld Scholarship Trust Fund, 5. c/o Gary M. Krim, Trustee, 1311 Mamaroneck Avenue, Suite 340, White Plains, NY 10605.

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