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</o:shapelayout></xml><![endif]--></head><body lang=EN-US link=blue vlink=purple><div class=WordSection1><p class=MsoNormal>2013 APPLICATION FORM <o:p></o:p></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal>Please print or type clearly.<o:p></o:p></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal>Applicant's Name Permanent Address Telephone Current Address (if different from above) Telephone E-mail address Currently enrolled full-time: College/University Name & City Year of Study in 2012-13: Freshman Sophomore Junior Graduate Student: Year Professional Student: Year Senior<o:p></o:p></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal>List Institutions Previously Attended (High School and/or College):<o:p></o:p></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal>Attach the following documents:<o:p></o:p></p><p class=MsoNormal>1. Applicant's Letter: Describe your career goals and how our scholarship might help you in achieving them. Give us a brief biographical sketch — tell us about your academic interests, your extracurricular activities, awards/honors you may have received and any community service you have been involved in. Also please describe your financial need.<o:p></o:p></p><p class=MsoNormal>2. Two Letters of Recommendation: From teachers, professors, employers or other professionals who know you well.<o:p></o:p></p><p class=MsoNormal>3. Official academic transcripts: Post secondary students should obtain transcripts from all colleges/universities attended. High school seniors should obtain them from current and any previous high school attended.<o:p></o:p></p><p class=MsoNormal>4. State Officer's Letter: A letter from a state officer of the National Federation of the Blind of Connecticut confirming that you have discussed your application with him or her. Call our state office for help on this.<o:p></o:p></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal>Applicant's Signature Date<o:p></o:p></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal>Mail your completed application and/or address any questions to: National Federation of the Blind of Connecticut<o:p></o:p></p><p class=MsoNormal>477 Connecticut Boulevard, Suite 217 East Hartford, CT 06108 (860) 289-1971 www.nfbct.org<o:p></o:p></p></div></body></html>