CWA6508 Sholorship Form. Fill Out And Give To Your Steward Or 
Mail In To:
		
		CWA6508 Local
		2723 Foxcroft Road, Suit 201
		Little Rock, AR 72227


I am: [ ] a member of Local 6508
      [ ] a relative of a member of Local 6508

If a relative, name of member and relationship:
____________________________________________________


Name:______________________________________________________________

Address:___________________________________________________________

Telephone Number:__________________________________
 
Name of College, University, or other education institution:

__________________________________________________


I agree that Local 6508 may verify my enrollment in the above institution 
in order to be eligible to receive the Local 6508 Scholarship:

         ____________________________________________			                                         
				 
                       Signature of Applicant: 
											                                                                                       
                       Date:________	
											 										
		     ____________________________________________
                       Signature of Member:
											 
                       Date:________