SCHOLARSHIP APPLICATION 2017
A. Name _____________________________ Telephone ( ) ______________
City ___________________________State ______ Zip __________
Sponsor Name _________________________________
Note that the applicant and sponsor should both be descendants of Nathaniel Dickinson (1600-1672)
B. Accredited Colleges or Universities Accepted?
to which you have applied
1. _______________________________________ ________
2. _______________________________________ ________
3. _______________________________________ ________
Other college applications may be listed on the reverse side of this form.
Academic year for which applications have been made: ___________________
C. Please enclose the following:
1. Transcripts of your most recent two or more years of academic work. Photocopies are
2. A 250-300 word essay in which you provide information about yourself, your
accomplishments, your educational and career goals, and the value of this scholarship
3. Three letters of recommendation: (a) from a teacher or administrator of your current or
recently attended school, (b) from a
someone who knows you well but not in an academic or family context (e.g. an
employer, a clergyman, a leader of an organization to which you belong, etc.)
4. Evidence of acceptance to an accredited academic institution as a regular full-time
student in a degree program. Photocopies are acceptable.
5. Your family lineage, traced back at least to an entry in the book, DESCENDANTS OF