Student Name:_________________________________________________________
   G.P.A.:_______________________ Class Rank:______________________________
   Guidance Counselor’s Name:______________________________________________
   College Degree/Certificate you plan to receive:_________________________________
   Number of family members (including yourself) in your household:___________________
   Number of college students (including yourself) in your household:___________________
   Total family income per year (circle one):

                  less than $25,000
                  $26,000 to $50,000
                  $51,000 to $75,000
                  more than $75,000

   Write a brief essay (500 words, typed and double spaced ) about the person you most admire and how this person influenced your life.

   SIGNATURES:
    student____________________________________   date____________________
    parent/guardian______________________________   date____________________

   ATTACH TO THIS THE FOLLOWING:

• Completed Graduate Recognition Questionnaire
• Your 500-word essay
• Verification of acceptance to a college or technical school
• Two written recommendations from a school administrator, guidance counselor, or teacher attesting to your academic achievements and prospects for continued achievement.

   Mail complete application packet to:

                            CJNBW Scholarships
                            P. O. BOX 217
                            HIGHTSTOWN,NJ 08520

   Application packet must be received by May 19, 2000. Scholarship will be presented on June 10, 2000 at the Education Fair and Salute to African American High School Graduates which will be held at Coach & Four Restaurant, Route 33, Hightstown, NJ.

    All graduates will be honored at the annual Education Fair and Salute to African American High School Graduates on June 10, 2000 at Coach & Four Restaurant, Route 33, Hightstown, NJ.

Name: ___________________________  High School: __________________________
Address:   _____________________________________________________________
                _____________________________________________________________
Telephone No.: ____________________________   Date of Birth: _________________

Parent(s) or Guardian(s):  _________________________________________________

List all school, community and church activities you have participated in:
    ___________________________________________________________________
    ___________________________________________________________________
    ___________________________________________________________________
    ___________________________________________________________________
    ___________________________________________________________________
    ___________________________________________________________________

List all honors and awards you have received:
    ___________________________________________________________________
    ___________________________________________________________________
    ___________________________________________________________________
    ___________________________________________________________________

List the college or technical school you plan to attend:
    ___________________________________________________________________
    ___________________________________________________________________
    ___________________________________________________________________

Tell us about the special talents and characteristics which make you unique:
    ___________________________________________________________________
    ___________________________________________________________________
    ___________________________________________________________________
    ___________________________________________________________________

Give us a brief statement about your future plans:
    ___________________________________________________________________
    ___________________________________________________________________
    ___________________________________________________________________
    ___________________________________________________________________
    ___________________________________________________________________
    ___________________________________________________________________