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ISA Southern Chapter
is an affiliate of the
International Society of Arboriculture
Comments regarding this
site should be directed to
Dwayne Carter,
ISA Southern Chapter
Executive Director

 

Thomas G. Dedrick Memorial Scholarship


Application Form - Please print, fill out, and mail this form along with other application materials. All items must be received by February 15 at the address below:

Scholarship Chairman
International Society of Arboriculture Southern Chapter
213 Apollo Drive
Mt. Airy, NC 27030

 
1. Full Name:
 

 
2. Social Security Number
 
3. Home Address:
 
 
 
4. Phone:
 
5. College or University:
 
6. Mailing address of College or University:
 
 
 
7. Phone Number of the Financial Aid Office
of College or University:
 
8. Field of Study:
 
9. Are you a full-time student?

Yes

No

10. Are you a citizen of the United States of America and within the eligible geographic area?

Yes

No

I, the undersigned, have read the information concerning this scholarship and I understand the application instructions and governing rules. I agree to allow, upon selection, my name and general descriptions from the scholarship application materials to be used for promoting this scholarship program.
Signature:
 

Date: