2025 Local 140 Scholarship Application
2025 Local 140 Scholarship Application
2025 Local 140 Scholarship Application
1.
Student’s Name
2.
Students Social Security Number:
3.
Date of Birth
4.
Address, State, Zip
5.
Is applicant a dependent of member as defined by the IRS?
Yes
No
6.
I am applying for the (Fall, Winter, Spring or Summer semester)
7.
I will be a: Freshman, Sophomore, Junior or Senior
8.
Name, Address, Phone Number of the College or University that will be attended
9.
Name of High School graduated from:
10.
Parent or guardian’s name, address, state and zip
11.
Local 140 Members Name, Phone Number and personal email address
12.
By our signature (name) we agree to abide by the attached qualifications of Local 140 and that all matters of dispute shall be decided by the Executive Board of Fire Fighters Local 140.
13.
Signature (Name) of applicant
14.
Signature (Name) of member