Applicant #

(FSF use only)

FAIRVIEW SCHOOL FOUNDATION

The Charles G. Simonian Scholarship

A $300.00 scholarship is awarded each year in memory of Charles Simonian to a Fairview High School graduating senior planning on furthering his/her education at any campus of The Pennsylvania State University. Mr. Simonian, former proprietor of Chico’s Traveler’s Inn, was a great supporter of education and an avid Penn State fan.

To be considered for this award, please type the following information. Applications must be received by March 30, 2012. Applications submitted after this date will not be considered.

Please submit the application to:

Fairview School Foundation

Attn: Dr. Katy Wolfrom

Central Administration Building

7466 McCray Road

Fairview, PA 16415

In order for this to be a fair and anonymous process, please indicate your name only on this cover sheet.

NAME: PHONE:

ADDRESS:

CITY: ZIP CODE:

Academic Data:

GPA

(Adjusted on a 4.0 scale) Guidance Counselor’s Signature

I certify that all statements made in this application are true.

Applicant’s Signature & Date Parent/Guardian Signature & Date

Applicant #

(FSF use only)

Please share your reasons for selecting Penn State University:

How will your education be funded?