**Please read the Application Criteria prior to proceeding.**

By Mail:

Download application, and complete.

Mail Applications to:
Cindy Asplund Memorial Scholarship
407 17th Avenue
Bloomer, WI 54724


Applicant Information:
Your Name (required):

Your Email (required):

Your Date Of Birth (required):

Your Street Address (required):

Your City (required):

Your Zip (required):

Family Information:
Your Father's Name:

Your Father's Occupation:

Your Mother's Name:

Your Mother's Occupation:

Your Siblings Names and Ages:

School Information:
Name of College to Attend (required):

Your course of study (required):

Your activities and organizations:

What offices did you hold?:

Summarize Your Reason to Pursue a Science Degree (required):

High School Transcript (required):

Letter of Recommendation #1 (required):

Letter of Recommendation #2 (required):

Letter of Recommendation #3 (required):

Enter the code you see: