Jessamine S. Henderson Memorial

Adult Education Scholarship Fund Application



Name of any schools you may have previously attended including dates and degrees or certificates awarded.
Please provide the names of 3 individuals (not relatives) as references including contact information and years known.
0/200 words
I have completed the Free Application for Federal Student Aid (FAFSA) and may be required to furnish it to JSH Fund. If FAFSA Is not available information regarding income/living expenses and cost of education if requested.

I hereby authorize the JSH Fund to publicize my name, picture and any scholarship I receive. I authorize the JSH Fund to examine my educational and financial aid records for scholarship purposes. I certify that all information provided in this application is accurate.

I understand that the JSH Fund may withdraw my award due to unmet scholarship criteria and/or fund availability and that any scholarship I may be granted must be used within 180 days of the date of the award. I certify that I am currently a resident of either Somerset or Hunterdon County, NJ. I understand that I will forfeit any scholarship award if I move from Somerset or Hunterdon Counties, NJ.

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