APPLICATION FOR BOOK ALLOWANCE

Henry McNeal Turner Scholarship Program, 2009

NAME __________________________   ________________________

                              FIRST                                                    LAST                

SSN ________________________

SCHOOL ID NUMBER ________________________

HOME ADDRESS ____________________________________________

                                ____________________________________________

                                        CITY                          , STATE              ZIP CODE

HOME PHONE ________________________

COLLEGE/VOCATIONAL SCHOOL ATTENDING

____________________________________________

____________________________________________

              CITY                           , STATE          ZIP CODE

DATE RETURNING TO SCHOOL _____________________                      

 MONTH  /  DAY  /  YEAR

SCHOOL MAILING ADDRESS

____________________________________________

                                 ____________________________________________

                                         CITY                          , STATE              ZIP CODE

EMAIL ADDRESS       _________________________________

MAJOR        _________________________________

CLASSIFICATION       _________________________________

Please submit by July 30, 2009

Application/request can be submitted to the church office or handed to the following contact person:

   Mrs. Demetra Washington (301) 924-4854 or Mrs. Patricia Browne (301) 512-5011