Bill Estes Memorial SCHOLARSHIP INTEREST APPLICATION       

NAME: ____________________________________________  DATE OF BIRTH:_______________

HOME ADDRESS: __________________________________________________________________

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TELEPHONE: ____________________________EMAIL ADDRESS _________________________

1) Did you serve HONORABLY in the United States Military Service?

                                                                        _______  YES    ________ NO

2) Are you a disabled veteran?   

                                                                        _______  YES    ________ NO

    _______  Service connected    ________ Non-service connected disabled.

3)  Please indicate your current level of education: _____________________________________

4)  Where do you plan to apply this scholarship? Or what school will you attend?      _______________________________________________________________________________

5)  What are your career goals?

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Please note only residents of Santa Clara and San Benito counties are eligible for the scholarship.

Please mail completed application to:

VEC Santa Clara, 420 South Pastoria Avenue, Sunnyvale, CA 94086 by July 4, 2006.               

Signature ______________________________                                           Date _________________