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International College Counselors Scholarship Entry Form 2011

 

Please complete this form in full and attach it to the front of your essay submission.

 

Name: _________________________________________ 

                                                                                                    .

Grade level :  ___________                 .    

 

Address: ________________________________________   

                                                                                   .

City:   _____________________    State:  _____      Zip:   __________                    

 

Telephone: (  _____ )  _________________

 

Email:   ____________________________                                                                                                      

 

School: _________________________________________

 

School Address:  _________________________________________________

 

 

Certification

I hereby certify: 1) I have read the rules of this essay contest; 2) This essay is my own work product; 3) I understand that my essay will not be returned to me and will become property of International College Counselors and that the judges decisions are final; 4) I am eligible to enter this contest, and if selected, able to be recognized as a winner of this contest.

 

Date:    ___________________         Signed: _______________________      

                                                .

 

Guardian name _____________________ Signature: _____________________

 

 

Please remember the theme of this contest: What Makes a Good College Education?”

 

Please mail all essays to:

International College Counselors

4700 Sheridan Street, Suite J

Hollywood, FL 33021

 

Please call Barry Liebowitz (954) 414-9986 or email barry@internationalcollegecounselors.com if you have any questions. The deadline for submissions is February 28, 2011.