Scholarship Form

Anton and Frances Prusa Family Memorial Scholarship: Cherokee Strip Historical Society, Noble County Chapter; Perry, Oklahoma 73077

The Prusa Family Memorial Scholarship is made possible by donations, special gifts, and memorials to the Cherokee Strip Historical Society. It is a $1,500 scholarship awarded by the board of the directors to a sophomore level or above college student. Preference may be given to students within history, social studies, or museum sciences. In addition to filling out this form, please mail (1) A current transcript with grade point average, (2) proof of registration, and (3) three letters of recommendation to: CSHS Scholarship Committee c/o Cherokee Strip Museum, 2617 West Fir Avenue, Perry, Oklahoma 73077

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First Name

Last Name

Middle Name

Date of Birth (YYYY-MM-DD)

Mailing Address

Permanent Address

Phone Number

College Classification

High School Graduated From

Year of Graduation

Length of Noble County Residency

Degrees Earned

Degrees you are Working Toward

Major/Minor

Name of College/University that you Attend

When Semester Will you be Enrolling?

Relevant Work Experience:

Community Service:

Statement of Career Goals and Aspirations:

Additional Information Applicant Wishes the Selection Committee to Know: