Applications must be

submitted electronically to RMC@bignet.org.

[For additional information, contact Grantham University at www.grantham.edu]

Name of Applicant _____________________________________________________

Name of BIG Region XI Family Member (if any) _____________________________

Address ______________________________________________________________

(Street Address)

______________________________________________________________

(City) (State) (Zip Code)

Telephone Number: Work ______________ Home _________________

Current Position Title: __________________________________________

Email Address: _______________________________________________

Submit essay on “Why I Should be Awarded a BIG Region XI Scholarship.”

High School or College Transcript Attached. Yes _____ No _____

Present Cumulative Grade Point Average (GPA) __________

Anticipated Date of Graduation ______________________

Are you a current and active member of BIG Region XI in good standing for three years or more? Yes ___ No ____

Name of Chapter ___________________ Name of Region _________

Member-at-Large _______ Membership Number _______________

Are you a member of BIG Region XI Member’s immediate family? ____________

(Relationship)

Activity/Organization Position Held Accomplishments

________________ _________________ _________________

Special Honors/Awards: ________________________________________

College/University Enrolled or Intended Potential Major or Field of Study

______________________________ __________________________

Formally Accepted Yes ____ No ____

I certify that all of the above statements are my own and are true. Further, it is understood, if selected for this scholarship, I must attend no later than the Fall Semester of 2008-2009 academic year. Also, if requested, I will provide a progress report on my studies to the BIG RMC Chapter during the scholarship year.

______________________________ Date: _________________________