NNRC 2011-2012 Textbook Scholarship Application

Textbook scholarships (up to $50 per person) are available to NNRC members who are currently under contract or are full-time students pursuing a degree in the field of reading. Please submit the complete application with your receipt(s) attached to Carol Clark –

cclark@ycsd.york.va.us by November 30, 2011.

Name of Applicant: ____________________________________________

Address: _____________________________________________________

City, State, Zip: _______________________________________________

Telephone: W_________________C________________H______________

Email: _____________________________fax ________________________

Present Position/Title:____________________________________________

Place of Employment: ___________________________________________

Address:______________________________________________________

City, State, Zip:_________________________________________________

Have you previously received this scholarship? If yes, when: ______________________________________________________________

College/University: _________________________Term Enrolled: ________

Course(s): _____________________________________________________

______________________________________________________________

Text Title(s): ___________________________________________________

______________________________________________________________