(Please print clearly)
Date ____________________________
Please send instructions as to how I can compete for a scholarship award.
I will be a senior in the 1999-2000 school year.
I am the son daughter of retired active deceased letter carrier _______________
Of Branch____________ City______________ State______________
My name is ______________________________________________
My address is__________________________________________________
City_________________ State______ Zip ____________
Signature of NALC parent member
(or spouse if deceased)________________________________________
NALC parent's Social Security # _________________________________
Signature of Branch officer ______________________________________
Title of Branch officer__________________________ date_____________