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Online Application

Applications & Recommendations Mail To:

 

Remember Dan and Mike

Scholarship Review Committee

93 Sheppard Ln.

Nesconset, NY 11767

 

Email to:

scholarship@rememberdanandmike.com

Online Application Form

*Only COMPLETE Applications from Smithown Seniors Will be Accepted

 

Eligibility:

First Name:

Last Name:

Home Address:

  

Phone Number:

Email Address:

School:

Smithtown High School West Smithtown High School East

 

Student Information:

GPA:

Grade (Seniors Only):

9th 10th 11th 12th

 

Tell Us about Yourself:

Extracurricular Activities:

(Separated by comas)

Awards:

(Separated by comas)

Memberships- Activities/Clubs:

(Separated by comas)

Other Accomplishments:

(Separated by comas)

 

Essay Requirements:

In two or three paragraphs (size 12 font), please respond to the following:

In your Estimation, what exemplifies good character, and how have you demonstrated this?

 

Attach Essay File Below:

 

***Guidance counselor and Teacher recommendations are now required.