Scholarship Application

"*" indicates required fields

First Name*

Middle Initial

Last Name*

Address*

Mailing Address City State ZIP

Phone*

Date Of Birth*

Email*

Name of Parents or Guardian*

Address*

Street Address City State ZIP

Anticipated Graduation Date*

High schools attended (include names and addresses)*

Please provide the following information
Additional pages may be attached as necessary.

Extracurricular activities, offices, and accomplishments*

Awards and Distinctions*

Community Involvement*

Employment History*

Career Goals*

Schools to which you are applying for admission*

Required Attachments

1. Official high school transcript. (Only official transcripts will be considered)
2. Letter(s) of recommendation (no more than 3) from high school counselor, principal, teacher, employer, pastor, or other advisors or mentors
3. Required Essay: Please tell us from your past and current experiences (either academic or personal) what attracts you to your projected areas of study and explain your interest (maximum 750 words)

Upload Documents*

Drop files here or

Max. file size: 5 MB.

Optional Attachments

1. SAT or ACT scores report
2. Copies of Academic Awards

Upload Documents

Drop files here or

Max. file size: 5 MB.

Applicant Acknowledgement: I hereby certify that all of the information provided by me in this application (or any other accompanying or required documents) is correct, accurate and complete to the best of my knowledge. I understand that the falsification, misrepresentation, or omission of any facts in said documents may render this application void and will be cause for denial of a scholarship.

Signature*

Consent*

I agree to the privacy policy.

Date*