Welcome to

St. Dominic High School

Glennon W. Obrecht
Memorial Scholarship
St. Dominic High School
31 St. Dominic Drive
O’Fallon, MO 63366

Social
Student’s Name: ________________________________ Security: ________________________

Street Address: __________________________________________ Phone: ____________________

City:____________________________________ State: _________ Zipcode: _______________

Parent’s Name: Father:____________________ Mother: ____________________
Parent’s Daytime Number: Father:____________________ Mother: ____________________
Number of
In what parish is your family registered? _______________________________ Children: _________

School student attends presently : _________________________________ Grade:_________
All applicants for this scholarship must fill out and return the PSAS Student Aid form. Go to SDHS website
www.stdominichs.org, click PSAS form and print. Or form may be obtained from school office.
Student applicant should answer the following questions:

1. What academic areas have you most enjoyed in the current or more recent school year and why?

2. What occupation interests you as a possible career choice and why?

3. List extra-curricular activities (organizations, sports, clubs, etc.), community, parish or other service activities you have been involved with in the last two years. What has this meant for you?

Extra-curricular:

In the Community:

In the Parish:

Other Activities:

4. Explain briefly why you would like to be considered for this scholarship?

THIS FORM SHOULD BE COMPLETED AND RETURNED BY TUESDAY, MARCH 25, 2008 TO:
Glennon W. Obrecht Memorial Scholarship
St. Dominic High School
31 St. Dominic Drive
O’Fallon, MO 63366