NYS FOP  Lodge 25
Scholarship Application
(print this page using your internet browser print function)
NYS FOP Nassau County Lodge 25 will be offering $250.00 scholarships to children of members of
Lodge 25 who are in "Good Standings".  These scholarships will apply to High School seniors who
are planning to continue his/her education in some form for the Fall 2007 semester.

Recipients will be randomly chosen by a lottery drawing which will take place at the Spring
Scholarship Meeting to be held on Tuesday, May 8th, 2007 - 7pm at NYS FOP Headquarters in
Hicksville.  If not present, winners will be notified by telephone.

These scholarship awards are in addition to scholarships awards offered by the New York State
FOP and members may apply for both.
Applications must be received by May 1st, 2007 to be eligible!
- - - - - - - - - - - - - - - - - - -
(cut on dotted line and return bottom portion only)
- - - - - - - - - - - - - - - - - - -
COMPLETE THIS FORM (TYPE or PRINT LEGIBLY) AND RETURN BY May 1st, 2007
MAIL TO:
ANNE POWERS, SCHOLARSHIP CHAIRPERSON
NYS FOP LODGE 25, INC.
PO BOX 787
MINEOLA, NY 11501
MEMBER'S NAME: ___________________________________________________________________

STREET: ___________________________________________________________________________

CITY: ___________________________________________  STATE: ___________  ZIP: ____________

TELEPHONE #: ___________________________________


CHILD'S NAME: ___________________________________________________  D.O.B.: ____________

SCHOOL CURRENTLY ATTENDING: ______________________________________________________

SCHOOL CHILD PLANS TO ATTEND: _____________________________________________________