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SCHOLARSHIP APPLICATION

Deadline: May 10, 2019

  First Name

  Last Name

  Address

  City

  Email

  Date of Birth 

  Name of High School

  State

  Phone

  Sex

  Cumulative GPA (4.0 scale) 

What college will you be attending in the Fall?

Are you the first person in your family to go to college?

High School Transcript

Upload File

Acceptance Letter/Proof of Enrollment

Upload File

Describe what volunteer work/community service has taught you    and how it has shaped who you are today. What are your plans      after college and how do you plan to impact your community?  (250-500 words)

STATEMENT OF ACCURACY

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By submitting this application, I hereby affirm that all the above stated information provided by me is true and correct to the best of my knowledge.  I also consent that if chosen as a scholarship winner my picture may be taken and used to promote the organization’s scholarship program. (Winner may waive photo due to unusual or compelling circumstances.)

 

I hereby understand that if chosen as a scholarship winner, I must be present at any potential awards ceremony, surprise, or reception in August 2019 to receive my scholarship award. 

 

I hereby understand that if chosen as a scholarship winner, it is my responsibility to remit to the organization the appropriate information for my scholarship to be paid directly to me or the academic institution that I will be attending in the Fall 2019.

 

I hereby understand I will not submit this application without all required attachments and supporting information. Incomplete applications or applications that do not meet eligibility criteria will not be considered for this scholarship.

Thanks for your submission!

  Zip Code

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