American Savings Foundation

Remember, you must be a resident of one of the 64 Connecticut towns served by the foundation to apply. Do not use STAPLES or 2-sided paper.
	Scholarship Application 2010-2011
Page 1 - Application Certification Page PRINT this page and submit with all required attachments You must submit a copy of this application certification page along with all required attachments in addition to filling out the online application. The deadline for all materials is March 31, 2010. Mail Attachments Package materials to: American Savings Foundation - 185 Main Street - New Britain, CT 06051
Full Name:		Date of Birth:
Email Address:		Cell Phone:
Home Phone:
Application Checklist:
Online application must be completed at www.asfdn.org and submitted by March 31, 2010 Signed Application Certification (below) ALL PAGES of your Student Aid Report (SAR) showing a valid EFC and all family financial data. Estimate from FAFSA on the web (www.fafsa.ed.gov) will be accepted until final SAR is received. High School and/or College Transcript(s) High school seniors & college freshman only: Academic Profile Page (Page 2) Two letters of recommendation (Page 3) Waterbury/New Britain residents who are applying for the Robert T. Kenney scholarship ____ initial here. A letter of nomination and list of all volunteer activities are required.
APPLICATION CERTIFICATION - In submitting this application, I certify that the information provided is complete and accurate to the best of my knowledge. If requested, I agree to give proof of information I have given on this form, including copies of any US Income Tax Returns. Falsification of information may result in termination of any scholarship granted. This application and attached materials become the property of American Savings Foundation.
Applicant's Signature:	__________________________________	Date:	________
Parent/Guardian Signature:	__________________________________	Date:	________
Required unless you are considered independent on your SAR. Only students who have answered YES to one or more questions in SECTION 2 (Student Dependency Status) of the FAFSA are independent. After you PRINT this page, proceed to PAGE 2

Required unless you are considered independent on your SAR. Only students who have answered YES to one or more questions in SECTION 2 (Student Dependency Status) of the FAFSA are independent.