Great Lakes Institute of Photography Scholarship Application Name: ____________________________ Ph: __________ Address: ________________________________________ Present Employment: ______________________________ How Long: ________ Position/Duties__________________ HISTORY OF PHOTOGRAPHIC INVOLVEMENT Schooling: _______________________________________ Employment: _____________________________________ Other: __________________________________________ Membership in any Photographic Associations: _______________________________________________ _______________________________________________ How Long: ______________ Which Scholarship would you like to apply for: Mark X for your choice (s). Only one scholarship awarded per applicant. Helen Yancy Honorary*___ ($500) PPM New Member* ___ ($300) PPM President*___($300) Runnels/Culver memorial ____($300) Pecknyo/MTPPA Honorary ___($300) GLIP Memorial ____($300) *requires PPM Membership I am applying for: Course: _______________________________________ Instructor: _____________________________________ Why have you selected the course you are applying for and what do you expect to gain from it? _______________________________________________ _______________________________________________ _______________________________________________ _______________________________________________* *additional comments on separate paper Explain how you would benefit from a Scholarship: _______________________________________________ _______________________________________________ _______________________________________________ _______________________________________________* *additional comments on separate paper Describe your long range goals for photography: _______________________________________________ _______________________________________________ _______________________________________________ _______________________________________________* *additional comments on separate paper Photographic References (Photographers, Labs, Suppliers etc.) 1. Name ________________________________________ Address ________________________________________ Phone __________________________________________ 2. Name ________________________________________ Address ________________________________________ Phone __________________________________________ 3. Name ________________________________________ Address ________________________________________ Phone __________________________________________ Application must be received by the end of March. Please Mail to: John Marion 66990 Gratiot Ave. Richmond, MI 48062