UV Brooklyn Scholarship Form

UNA VOCE BROOKLYN Catholic High School Student
$1,000 TUITION SCHOLARSHIP
Information Form

STUDENT INFORMATION:

Name: ____________________________________________________

Mailing Address: _________________________________________________________

_________________________________________________________

Phone number: ______________________________________________

Email address: ______________________________________________

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

TO BE FILLED OUT BY SCHOOL REPRESENTATIVE (Teacher/Administrator):

I confirm that the student above is a student at _________________________

___________________________________ (High School).

Signed: ______________________________

Date: _______________________________

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~


TO BE FILLED OUT BY UNA VOCE REPRESENTATIVE AT MASS:

I confirm that the student above attended the traditional Latin Mass at

St. Cecilia’s R. C. Church, 84 Herbert Street, Brooklyn, NY

on Friday, November 21, 2008


Signed: _______________________________________ (Una Voce Representative)



~~~ PLEASE SUBMIT THIS COMPLETED FORM WITH YOUR ESSAY! ~~~
FOR MORE INFORMATION OR ADDITIONAL FORMS PLEASE EMAIL:
indirasweeny@hotmail.com www.uvbrooklyn.org