Durham Scholarship Application - Fillable

       Town Of Durham                          Application Number: ________
                                                         (For Office Use Only)
Scholarship Application
         630 Hallowell Road                           www.durhamme.gov
        Durham, Maine 04222                            Tel: 207-353-2561
                                                       Fax: 207-353-5367
           Incorporated 1789

APPLICANT INFORMATION:

Section 1. Personal Information

First Name: ____________________________             Last Name: _________________________

Home Address: __________________________________________________________

Mailing Address: ________________________________________________________

Date of Birth: ______________________

Cell Phone: ____________________________             Home Phone: ________________________

Email Address: __________________________________________________________

Parental/Guardian Information (if applicable):

Parent(s) Name: _________________________________________________________

Parent(s) Email: _________________________________________________________

Parent(s) Cell Phone: _____________________________________________________

CERTIFICATION AND RELEASE AUTHORIZATION

I certify that this information is complete and accurate. I authorize the release of this information to confirm and verify this application. In understand that if I am awarded the scholarship, it will be released after successful completion of my first semester. I further grant unto the Town of Durham, Maine the right to use my name and/or photograph in connection with this Scholarship Program.

___________________________________                          __________________
Signature of Applicant                                       Date

Application Number: _____________

(For Office Use Only)

Section 2. Academic Information

Name of High School: __________________________________________________________

High School Graduation: Month: _____________________                  Year: _______________

High School Rank: ______________ out of _____________                 GPA: _______________

SAT/ACT Scores: _______________________________

Post-Secondary School: ___________________________________________________

Anticipated Major(s): _____________________________________________________

Section 3. Activities and Interests:

A. List and briefly describe your high school extracurricular activities (e.g. memberships in organizations, sports, etc.):

Organization Involved          Position Held                 Date of Involvement

Brief description of your responsibilities:

Application Number: _____________

(For Office Use Only)

B. List and briefly describe volunteer activities in which you have been involved:

Organization                  Activity                      Date of Involvement

Brief description of how you participated:

C. List honors or academic awards you have received (e.g. scholarly activities, research, etc.):

Award/Honor                     Institution/Organization        Date

Application Number: _____________

(For Office Use Only)

D. List and briefly describe any work experience:

Position                     Employer                       Dates of Employment

Brief description of your work responsibilities:

Section 4 – Short Essays:

A. What is the purpose of post-secondary education and how will it benefit you?

Application Number: _____________

(For Office Use Only)

B. Why should you be chosen to receive the Durham Community Scholarship?

C. How will you be financing your college education and how will a scholarship impact your plans?

D. Is there any other information that we should know about you? This is your opportunity to include information that is not contained in other areas of the application. Please be specific.

Submitting your application:

Please submit the following to be considered for the Durham Community Scholarship:

1. Completed application form

2. Up to two (2) letters of recommendation from your teachers, counselor or community leaders

3. Copy of the applicant’s high school transcript

4. Copy of SAT/ACT scores

5. Letter of acceptance to accredited academic, vocational, professional or technical school, college or university (if available)

This application is due on May 4, 2026 before 5:00 p.m.

Return application to: Town of Durham Scholarship Application 630 Hallowell Road Durham, ME 04222

Please direct any questions to: Kendra O’Connell peaksi1@comcast.net

Your request for a scholarship becomes valid ONLY when the application and all supporting documents are submitted.