The Shirley Ann Kalaniopua Nakamura Memorial Fund
Scholarship Application
2004
791 Sunset Ave.
Honolulu, HI 96816
Please complete all parts of this application. One application for each person applying for this scholarship. All information is confidential and will be used by the Board of Directors and the selection committee for the dole purpose of determining this scholarship.
Full Name:________________________________ Date of Birth_______________
Parents: ________________________________(Father) Work Phone________________
________________________________(Mother) Work Phone________________
Address: ________________________________ Home Phone_______________
________________________________
How many years have you paddled for Waikiki Surf Club? _________
Do your parents, brother(s) or sister(s) paddle for Waikiki Surf Club? Yes No List their names.
Statement of Financial Need: Write a short statement explaining your need for his scholarship.
On the back side of this application, please write a short essay about why you feel you should be a recipient of this scholarship. Your essay should also provide us with some general information about you. (This essay must be completed for your application to be considered.)
Signature of Applicant:__________________________ Date:_______________
Signature of Parents: __________________________(Father) Date:_______________
__________________________(Mother) Date:_______________