THE FLORIDA SOCIETY

COLONIAL DAMES XVII CENTURY

ANNE MASSEY GENERAL SCHOLARSHIP

MEMORANDUM TO HIGH SCHOOL GUIDANCE OFFICE

The Florida Society Colonial Dames XVII Century sponsor a $1,000.00 scholarship to a Florida
high school senior who will be attending a Florida four-year college or university or an accredited
Florida community college. The student must be enrolled in college full time, show financial need
and have a 3.0 GPA or above. The student must submit an acceptance letter from college of choice,
a transcript of grades, two letters of reference, and one page telling his/her aims, ambitions and
financial need.

The Chapter Scholarship Chairman will furnish applications to Guidance Offices. The
application must be filled out completely and returned with all required information and shall
be postmarked on or before April 1 to the address below. No exceptions will be made.

The winner of the scholarship will be announced in May. The $1000.00 award will be sent directly
to the winning student’s college

RETURN TO Anne Massey Scholarship, Chapter Chairman:

Name: Julia Saldivar
Address: 2637 Country Side Dr., Fleming Island, FL 32003

Form for use in: 2017-2019 only

 Florida Society
COLONIAL DAMES XVII cENTURY

ANNE MASSEY GENERAL SCHOLARSHIP

Deadline: April 1
Amount: $1000.00

Date ________________ High School ___________________________________

Name _____________________________________________________________
Address ___________________________________________________________
Phone ______________________ Email ________________________________
Date of Birth ______________
College accepted by and address: ______________________________________
Estimated total cost of schooling year____________________________________
How much can applicant provide of his/her expenses?_______________________
Savings for college __________________________________________________
Father’s occupation __________________________________________________
Mother’s occupation _________________________________________________
Name and ages of dependents in family other than applicant __________________
_________________________________________________________________
We attest that all information in this application and all attachments constitute a true
and accurate record.
____________________ _____________________ ____________________
Signature of Father Signature of Mother Signature of Applicant

The following are also required:

1. Copy of college acceptance by a Florida 4 year accredited College/University or a 2
year accredited Florida Community College.
2. Extra curricular activities.
3. A one page summary of aims, ambitions and why you need financial aid.
4. Copy of transcript record (with GPA of 3.0 or higher).
5. Recommendation from a teacher or principal and one other non-family member.
6. Plan to attend college full time before the end of the current calendar year
7. You must furnish your student ID number or Social Security number to the State
Scholarship Chairman if you are awarded this scholarship.

RETURN TO Anne Massey Scholarship, Chapter Chairman

Name: Julia Saldivar
Address: 2637 Country Side Dr., Fleming Island, FL 32003

Form for 2017-2019 use only