WILLIS SCHOLARSHIP FOUNDATION APPLICATION

In conjunction with the

Kansas Governor’s Annual One Shot Turkey Hunt

Date:  ___________________________

Applicant's Name:______________________________________________________________

                                 First                                        Middle                                    Last

Home Address:________________________________________________________________                                                                                            Number/Street                    

                                      ____________________________________________________________  City                                                                          State                       Zip

 School Address (if available):                                                            _______________________________________

                                         Number/Street

                                      _____________________________________________________________

 City                                                                 State                       Zip

Home Phone  (____)_________      __  School Phone(        )_    _         __

e-mail:_________________________________

School/University attended: _____________________________________________________

                                                                                                                School                                                    Major                      G.P.A.

                                                     ______________________________________________________

                                                                                                                School                                                    Major                      G.P.A.

Honors, Awards, Scholarships: ___________________________________________________

            ________________________________________________________________________

            ________________________________________________________________________

Job History: ___________________________________________________________________

            ________________________________________________________________________

            ________________________________________________________________________

Hobbies: ______________________________________________________________________

 ________________________________________________________________________

Please return to: Kansas Governor’s Turkey Hunt, Attention: Willis Scholarship

Foundation, Inc., P. O. Box 32, El Dorado, KS  67042