Home Gujarati Samaj of St. Louis - Scholarship Award
    

Registration Form:*Please fill this form and send the printed copy along with your
essay to the address below.
 
Student’s Name:
 
Parents' Name:   
 
Home Address:    
   
Street: 

City: 

State: 
Zip:     

 
Contact Information:
Home: 
Cell: 

Email (student):
Email (parent):
Last grade completed:
School attending:

ACT/SAT Score : (must provide a copy of results)
School Grades : (must provide a copy of transcript)
Essay : Write an essay about the importance of our gujarati culture in USA
Maximum 1000 words
Deadline: July 31, 2006
 

Please mail the required information with this registration form to by July 31, 2006:
Shantubhai Bhakta
16627 Kehrs Grove Dr .
Chesterfield MO 63005
Phone: 636-532-5863