HGA and Dendel Scholarships Application

Name: ___________________________________________________________

Email Address: ___________________________________________________________

Social Security or Tax Identification Number: _________________________________

Applicant Number (to be assigned by Scholarship Chairman): _______________________

Street Address: _____________________________________________________

City: ____________________________________________________________

State/Province: _____________________________________________________

Zip/Postal Code: ____________________________________________________

Phone Number: _____________________________________________________

Date of Birth: ______________________________________________________

Alternate or Permanent Address: ___________________________________________________

City: ____________________________________________________________

State/Province: _____________________________________________________

Zip/Postal Code: _____________________________________________________

Phone number: ______________________________________________________

Please include the name and address of your local newspaper for publicity purposes:

____________________________________________________________________

To the best of my knowledge, all statements and accompanying information in this application are true and correct. I have read the rules and regulations and agree to abide by them. I give HGA permission to publish images of my work.

Signature: _________________________________________________________

Date: ____________________________________________________________

Applicant Number (to be assigned by Scholarship Chairman): ________________________

1. Circle your highest level of education:

high school

college 1 2 3 4

graduate school 1 2 3 4

2. Are you a member of HGA? yes no

3. Please describe your study goals and how they fit into your future plans.

4. List membership in other fiber-related or professional organizations:

5. List any exhibits in which you have participated (include dates):

6. List awards and honors you have received:

7. Name and address of the school you are currently attending, if applicable:

8. Name and address of the school you wish to attend:

9. Please list the names and daytime phone numbers of two people who are knowledgeable about your work and your work habits.

Scholarship image record sheet.

Send this application and other required materials to:

Handweavers Guild of America, Inc.
Scholarship Committee
1255 Buford Highway, Suite 211
Suwanee, GA 30024

Telephone: (678) 730-0010
Email: hga@weavespindye.org