Kosciuszko Foundation
2009 Historical Essay Contest
APPLICATION FORM
First Name ___________________________________________
Last Name: ___________________________________________
Address: ___________________________________________
___________________________________________
___________________________________________
Tel: ___________________________________________
Email: ___________________________________________
Age: ___________________________________________
School or University:
___________________________________________
(if applicable)
Title of the Essay: ___________________________________________
___________________________________________
Number of Pages:
___________________________________________
Mail by 07/01/09 to: Kosciuszko Foundation, Inc.
15 East 65th Street
New York, NY 10065
For more information call: (330) 666-7251