Scholarship Application

Step 1 of 3

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Personal Information

Student's Full Name

First Middle Last

Address

Street Address Address Line 2 City State ZIP Code

Date of birth

MM slash DD slash YYYY

Phone

Name of Parent/Guardian

First Last

Parent/Guardian Email

Parent/Guardian Phone

Academic Background

Current High School / Community College Name:

Graduation Date / Expected Graduation Date:

Current Cumulative GPA:

Intended/Current College or University:

Intended Major/Field of Study:

File

Max. file size: 2 MB.

Financial Need Verification

Household Size: Number of people living in the primary household.

enter numbers only

Estimated Annual Household Income:

Under $25,000

$25,000 - $50,000

$50,000 - $75,000

Over $75000

Federal Pell Grant Eligibility: Have you completed the FAFSA?

Yes

In progress

First-Generation College Student: Will you be the first person in your immediate family to attend college?

Yes

Special Financial Circumstances:

Please briefly describe any financial hardships or unexpected family expenses your household faces

Extracurriculars & Community Impact

Community Involvement / Volunteer Work

(List organizations, roles, and total hours).

School Activities & Leadership Roles

(Clubs, sports, student government)

Employment & Family Responsibilities:

List any part-time work, or significant family caretaking responsibilities, such as watching younger siblings or elderly relatives, that you manage outside of school hours

Essay

Personal Journey & Obstacles: Describe a significant challenge or adversity you have faced in your life. How did you handle it, and what did you learn about yourself through the process?

Limit essays to 250–500 words.

Upload a letter of recommendation

Max. file size: 2 MB.

Signature(Required)