The Daughters of the Pioneers of Washington
Walla Walla Chapter No. 12
SCHOLARSHIP APPLICATION
COVER SHEET
NAME ______________________________________________________
ADDRESS ___________________________________________________
___________________________________________________
PHONE NUMBER ______________________
AGE ___________ NUMBER OF SIBLINGS ____________
SCHOOL NAME _______________________________________________
ADDRESS ___________________________________________________
CLASS NEXT YEAR ____________________________________________
ACADEMIC PURSUIT __________________________________________
NAME – FATHER ______________________________________________
MAIDEN NAME – MOTHER ______________________________________
Applications accepted September 1stthrough May 1stannually
Send applications to: Judith Fortney, 310 E Chestnut St Walla Walla WA 99362 509-529-8210