New York Bowhunters, Inc.

Doug Kerr Memorial Scholarship

Application Form  

1. Name: _____________________________________________________________________

                             Last                                     First                                         Middle Initial

2. Home Address: ______________________________________________________________

                                                                           Number and Street

 ____________________________________________________________________________

                             City                                          State                                            Zip Code

3. Home Phone Number: (          )             ________________                                                                    

4. Date of Birth: _______________________________________________________________

5. High School Graduating From: _________________________________________________

   Address: ___________________________________________________________________

                                                                        Number and Street

____________________________________________________________________________

                             City                                          State                                            Zip Code

6. Name of college or university in which you plan to enroll.

    __________________________________________________________________________

7. List any other scholarships for which you have applied or received.

    __________________________________________________________________________

8. Name of Parent or Guardian: __________________________________________________

    Type of Membership in New York Bowhunters, Inc.:_______________________________

9. Have you ever attended a youth camp sponsored by New York Bowhunters, Inc.:         Yes            No

    If yes, where? _________________________________________

 Send completed application and essay to:    New York Bowhunters, Inc.

                                                                        Doug Kerr Memorial Scholarship Fund

                                                                        P.O. Box 619

                                                                        LaFayette, NY 13084