Amateur Radio Education Fund of Southwest Wisconsin
Scholarship Application Form
(Please print or type)
Name _______________________________________________________________________ LAST INITIAL FIRST
Address _________________________________________________________________
_________________________________________________________________________ CIY STATE ZIP CODE
E-Mail _________________ Call Sign ________________ License Class ____________
School you will attend ______________________________________________________
Location __________________________________________________________________
Have you been accepted _____________________________________________________
Graduated from _________________________________ Date _____________________
GPA ______________________ Advisor ________________________________________
On a separate page please list the following:
Your Amateur Radio activities and Interests:
School activities:
Community activities:
Attach a short composition that states “Why I think I deserve this scholarship”.
Signature ____________________________________ Date ______________ 20_____
Submit completed form to Ed Toal, W8471 State Road 39, Blanchardville, WI 53516 or ed@n9mw.com.
NOTE: We may request additional information or conduct interviews in order to further qualify applicants.