BOOK SCHOLARSHIP FORM

MONTGOMERY COUNTY AGGIE MOMS 2007-2008

Semester: _________________________________

Form Due: November drawing due December 31, 2007 (Fall Semester)

March drawing due April 30, 2008 (Spring Semester)

Student name: _____________________________________________________

Student address: _____________________________________________________

_____________________________________________________

Student phone #: _____________________________________________________

Aggie Mom/parent/guardian: __________________________________________

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Failure to submit copies of book receipts, student i.d., and student schedule will delay processing. Scholarship will not be awarded if deadline stated above is missed. Student should copy this form and attachments before sending to Montgomery County Aggie Moms.

Book receipts: _________________________

Student i.d.: _________________________

Student schedule: _________________________

Date submitted: _________________________

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For Use by Montgomery County Aggie Moms

Date received: _________________________

Date paid: _________________________

Amount: _________________________

Check number: _________________________