SCHOLARSHIP APPLICATION
The Fifth Annual
Knights of Columbus
Joseph M. Baniukiewicz Jr.
Memorial Scholarship
$750
All applicants must be a Worcester resident and a parishioner
or relative of a parishioner of Christ The King Church. Please forward
your completed application to the following address before May 26, 2008.
David Standring
255 Sycamore Drive
Holden, MA 01520
Full Name:_______________________________________________DOB:___________
Address:__________________________________________________
Street and Number
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City State Zip Code
Phone Number:___________________________________________________________
Social Security Number:______________________________Sex: ( ) male ( ) female
Does any family member belong to the Knights of Columbus: ( ) No
If yes:____________________________________________ ____________________
Name Relationship
Which college or university will you be attending:
Name:__________________________________________________________________
List the High Schools or Preparatory Schools you have attended:
School Address Dates
Attended
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In answering the following questions, please indicate the years involved.
(1 – Freshmen) (2 – Sophomore) (3 – Junior) (4 – Senior)
In what school activities (other than sports) have you participated?
Outside of school, what organizations have you been involved with?
Have you been a volunteer for any organizations?
Have you received any honors, awards, or scholarships?
Have you participated in any varsity sports?
Summarize your religious practices.
Father’s Name:___________________________________________________________
________________________________________________________________________
Occupation
Mother’s Name:__________________________________________________________
________________________________________________________________________
Occupation
List names and ages of siblings:
___________________________________________________________________________
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Essay Question: How do you foresee a college education helping you to achieve your
personal, academic, and career goals? (You can attached a separate sheet if you
wish)
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