Tom Pease Scholarship Application If you wish to apply for our annual Tom Pease Scholarship please fill out the form below. Sponsoring Lodge Number Applicant's Name Applicant's E-Mail Applicants Address Date of Birth (xx/xx/xxxx) Applicant's Social Security Number Whats Your Relationship To The Lodge? What School Will You Be Attending? What Is The School's Address? What Is The School's Phone Number?