THE MATTHEW R. ROW
SCHOLARSHIP FOUNDATION, INC.
Facebook: facebook.com/MattRowScholarship
Blogger: runforrow.blogspot.com
2017 Scholarship Application
APPLYING AS A HIGH SCHOOL SENIOR
Student’s Full Name: ________________________________________________________________________
Last First M.I.
Address: ________________________________________________________________________________
Street Address Apartment/Unit #
_______________________________________________________________________________
City State ZIP Code County
Gender (please mark one): _____ M _____ F
Phone No. ________________________________ Email: __________________________________________
Full name & relationship of deceased person(s): _________________________________________________
__________________________________________________________________________________________
The Foundation would like to honor the lost loved ones of all of our applicants at the Annual Run for Row
5K. If you would like your loved one’s name(s) to be included, please let us know if we have your
permission by checking one of the following: ________ YES ________ NO
Names and ages of siblings residing at home (if applicable): ______________________________________
__________________________________________________________________________________________
Please list parent(s)/guardian(s) name & contact information:
________________________________________________________________________
Last First M.I.
________________________________________________________________________
Last First M.I.
Address: ________________________________________________________________________________
Street Address Apartment/Unit #
_______________________________________________________________________________
City State ZIP Code County
Phone No. ________________________________ Email: __________________________________________
Name and address of current high school: ______________________________________________________
__________________________________________________________________________________________
Anticipated graduation date: _________________________________________________________________
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APPLICANT INFORMATION
EDUCATION & EXTRACURRICULAR ACTIVITIES