10. Name & adress of parent(s) or legal guardian(s)

14. The following items must be attached to this application in order for the application to qualify to be reviewed by the scholarship committee. Incomplete applications will not be considered.

- Two references from faculty. One must be from a teacher and one must be from an adult leader in an athletic program, community project or volunteer program you have participated in.

Have additional files you would like to attach?  Select upload file for each attachment you would like to add

STATEMENT OF ACCURACY

I hereby affirm that all the above stated information provided by me is true and correct to the best of my knowledge. I also consent that my picture may be taken and used for any purpose deemed necessary to promote the scholarship program.

REMEMBER

Please return all required materials to:

RD26 Foundation-Scholarships. C/O 

21Craigwood Terrace

Wilbraham, MA 01095