Chesapeake Post Scholarship Application

Name

First

Last

Home Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Email

Confirm Email

US / Eligible non-citizen

Yes
No

COLLEGE/UNIVERSITY ENROLLMENT

College Name

College Address

Expected Enrollment

Fall
Spring
Summer

Program of Study

Anticipated College Graduation Date

Name of Current or Last High School attended

Date OF Enrollment

High School Address

Date of High School Graduation Date

ARE YOU CURRENTLY A MEMBER OF SAME

Yes
No

HAVE YOU ATTENDED AN SAME EVENT(S)?

Yes
No

If “Yes” to either question above, please list the event and describe in no more than 50 words how your membership or the event you attended has benefited you.

Employer Name

Your Position

Hours per week

Duties

Employer Name

Your Position

Hours per week

Duties

Upload your essay

Click or drag a file to this area to upload.

Permission to release information

By signing this application, I authorize the SAME Chesapeake Post to confirm and/or release any information included on this application to the SAME Chesapeake Post Scholarship Committee Members. If awarded a scholarship I agree to allow my selection and photo(s) to be shared with the public (i.e., SAME web site and local newspapers). Furthermore, if awarded a scholarship, I agree to become a SAME Chesapeake Post member (free for students).

Applicant's 18 or over signature

Clear Signature

Date

Parent or Legal Guardian if under 18

Date

Parent or Legal Guardian Signature if under 18

Clear Signature

Chesapeake Post Scholarship Application

Chesapeake Post Scholarship Application 2026

Employer Name

Permission to release information