Name_________________________________________________ Date__________________________

Address_________________________________________ City__________________ Zip___________

Telephone______________________ Date of Birth_______________ HS Graduation date___________

Date of Confirmation________________________ Place of Confirmation_________________________

How long did you participate in a high school youth program?___________________________________

Where?_______________________________________________________________________________

Describe how long and in what ways you have participated in church related activities.

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What College, Vocational or Training School will you be attending?

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Eligibility: In addition to this completed application please submit:
1. A letter of recommendation from one high school teacher.
2. An endorsement by the parish youth minister or parish priest and/or parish director.
3. An essay describing your present educational goals and why you chose them.