| Date Scholarship will be used: Month __________________ Year __________
Name of Applicant: Last _______________________ First _________________
Address: ______________________________________________________________
City: _______________________________ State: __________ Zip: __________
Education: ____________________________________________________________
_______________________________________________________________________
Awards/Achievements: __________________________________________________
Place of Employment: __________________________________________________
Address: ______________________________________________________________
City: _______________________________ State: __________ Zip: __________
Current Position: _____________________________________________________
Total Gross Family Income: __________ # of Family Members in home: ____
ALTA Training Center of choice: _______________________________________
I wish to enroll in the: Semester ______________ Year __________ course
Please write a brief description indicating why you are interested in
taking the course and how you intend to use the training:
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Date: _____________________
In addition to completion of scholarship application for teacher training, two letters of recommendation must be received by the ALTA National Office no later than May 1st of the current calendar year.
ALTA National Office
13140 Coit Road, Suite 320, LB 120
Dallas, TX 75240-5737
FAX (972) 490-4219 |