Online Form – Knights of Columbus

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Applicant Information

NameApplicant's Name

E-mailApplicant's E-mail

Phone NumberApplicant's Phone

AddressApplicant's Address

City

State

Zip Code

High School Name

Graduation Year:

Eligibility Confirmation

Please confirm the following eligibility requirements:

Name of KOC Member:Council 14425

Relationshipto Applicant:

Educational Plans

CommentsInstitution Name, Location and if Admitted or Enrolled

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Personal Statement

Provide a personal statement (200-500 words) explaining your future goals and how this scholarship can help you achieve them. Attach additional pages if necessary.

WritePersonal Statement

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UploadPersonal Statement

Upload

Extracurricular Activities

This includes any Church Activities, Athletics, Clubs, Volunteer Work, Special Interest, and other relevant activities.

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Academic, Civic, and Church Awards or Honors

Cumulative GPA:

Commentsmore details

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Applicant Signature

By signing below, I certify that the information provided is accurate and complete to the best of my knowledge.

SignatureI agree to the terms and conditions

(Sign Here)

Clear Signature

Dateof appointment

Parent/ Guardian Name:full name

Contact Number:

Submission Instructions

Please submit this completed application along with your personal statement by Wednesday,
April 30, 2025.

For questions, please contact: Cody Smith at:

kofc14425scholorship@gmail.com