Metro New York Chapter

A. Philip Randolph Institute

Scholarship Application 2012
Please print all information
Name: ____________________________________________
Home Address: _____________________________________
_____________________________________
Phone: ___________________________________________
High School: _______________________________________
Grade Point Average: _______

Senior Ranking: _________

Accepted College: ___________________________________

Major: ____________________________________________
Extra Curricular Activities: ____________________________

Scholarship Check list for

district public high school
students

Essay: Attach a separate sheet

Completed Application

Letter of recommendation

What is the impact on labor and community partnerships

in the area of civil and human rights. Essay should be no
longer than 300 words, typed, double spaced and attached to
this application.
Applications should be returned by March 30, 2012 to:

Essay

Transcript

Rubye Jones, Chair

A. Philip Randolph Scholarship Committee
P.O. Box 455
New York, N.Y. 10016