Nassau County Sheriff's Department Emerald Society
Captain Nancy O'Doherty
Officer Walter DeMorris
Memorial Scholarship Application
Applicants Name________________________________________
Address_______________________________________________
City____________________State__________Zip______________
Members Name_________________________________________
2013/2014 School________________________________________
Grade / Level____________________________________________
Requirements:
1) Member must be a dues paying member in good standing for the TWO preceding years.
2)Applicant must attend a College, High School, Grammar School,
or Vocation School, that requires tuition to attend.
3) Applicant must be of the following relationship to the Member.
A) Spouse
B) Son or Daughter
C) Sibling (Brother or Sister)
D) Grandchildren
4) Scholarship must be used for tuition, room and board, or books and
supplies
5) Applications must be submitted to a Board Member by June 14th.
I have read the above and do so declare that I meet the requirements of the
Scholarship Commitee, and that the information on the application is true, and
that the funds will be disbursed in accordance with the requirements.
_________________________ _____________________
Applicant's Signature Members Signature
