Aiden McVicker Honorary

Grant Application

Application Instructions:

ü  Please type or print clearly.

ü  Attach typed essay, 1 page or less, about why you are applying for this grant and how it will effect your life.

ü  Attach any other pertinent information you deem helpful.

ü  Send completed application to: 

Jamey McVicker, President

127 East Evergreen Street

Cameron, MO  64429

Personal Information

Name  _______________________________  Social Security #   ___________________

Address  ______________________________________  Telephone  ________________

Father’s Name  ______________________________  Occupation  _________________

Mother’s Name  _____________________________  Occupation  __________________

School and Address________________________________________________________

______________________________________  School Telephone  _________________

Please describe what grant request is for:_______________________________________

________________________________________________________________________

Please describe your family’s biographical information:

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

Financial Information

Previous year family gross income  _________________  Dependants  ______________

Community Information

Please list all community, church, etc. activities and honors/awards:

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

Essay Question

Attach essay of 1 page or less, explaining the purpose of this grant, why you are applying for it, and what it would do for your family.

I hereby certify that the above statements are true and correct to the best of my knowledge.

______________________________________       ____________________

                Signature of Applicant                                              Date