Canton Community Health Fund
Use this form to apply for the annual Dr. Diters scholarship.
Please enter a valid email address for the student
List all schools/colleges to which you have been accepted
Enter your highest SAT Critical Reading score
Enter your highest SAT Math score
Enter your highest SAT Writing score
Statement of Financial Need for One Year: Tuition, room & board, fees, books, supplies, various personal expenses, transportation)
Statement of Financial Need for One Year: What is the expected Family Contribution amount?
Statement of Financial Need for One Year: What is the expected amount of your contribution?
Did you file a F.A.F.S.A? (Yes or No)
What is the number of family members in post-secondary education next year? (At least 1/2 time)
What other scholarships or financial aid from any source have you already been offered? Please state source and amount (Pell Grant, Awards, Scholarships, Loans, Grants).
FAILURE TO DISCLOSE ANY OF THE ABOVE MAY RESULT IN LOSS OF AWARD
Please report any unusual family or personal circumstances you feel warrant attention
Write a statement of your plans as they relate to your educational and career objectives and future goals.
Please list all activities that you participated in.
If you answered "Yes" to any of these questions, please Read More...
Canton Community Health Fund, PO Box 504, Canton, CT 06019
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