First Name: Middle Initial: Last Name: Street Address: City: State: --Select--ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip: Phone: Email: Gender: --Select--MaleFemaleN/A Hometown newspaper: Prefer to Attend: --Select--Saturday (February 18th)Sunday (February 19th)Either Day is Fine Who will be attending with you? Please indicate the number and names in the box provided. Number: Names: I have submitted the following documentation (check all that apply). All items should be submitted as soon as possible and must be submitted before participating in the competition. I Have Submitted: Application for Admission     $25 Application Fee     Essays or Writing Samples     High School Transcript     Letter of Recommendation     I understand that I must be a student new to Shimer and that I must complete an Application for Admission and the Free Application for Federal Student Aid (FASFA) to be considered for the Montaigne Scholarship. The information supplied by me on this application is true, complete, and correct to the best of my knowledge. I understand that all photographs and videos taken at Shimer or of Shimer events may be used in any College publications or released to the media, along with my or my child's name and city and state of residence. To sign, type in your name below. By signing you are stating that you have read and understand the above. If the applicant is under 18 years of age, his or her parent must sign. Signature: