Scholarship Application Form

Scholarship Application Form

Application Deadline - June 20, 2021
If selected, you will be asked for documentation to support the data you provide. Likewise, all correspondence and award agreements will be generated from the personal information submitted below. So, please use proper spelling, capitalization and punctuation. All winners will be notified on or before the July 10, 2021.
I agree to the information above. *

Yes No
Scholarship Applying for: *

Equality Nevada TransPride
I. Personal Data:

Tell us about yourself
Full Name *

First Name Last Name
Birth date: *

Month Day Year
Mobile No. : *

Area Code Phone Number
E-mail : *
Where the confirmation will be send to
Home Address : *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Optional Informations :

Information regarding gender, ethnic origin and race are optional. The information is requested for post-scholarship report generation only and in no way affects your selection for college scholarship awards. However, providing this information may increase your opportunities for scholarships where donors have asked that priority consideration be given to students meeting certain demographic criteria (such as minority status, parent's place of employment, area of study, etc.)
Gender:

Male Female
Are you a US citizen?

Yes No
Ethnic Origin:

Hispanic Non-Hispanic Not Indicated
Identify As:

LGBTQ+ Non-LGBTQ+ Transgender
Race? (Choose one or more):

White Black or African American Asian American Indian or Alaskan Native Hawaiian or Other Pacific Islander Non-Resident Alien
Please check veteran status (Check all that apply)

Veteran Child of a Veteran Grandchild of a Veteran Spouse of a Veteran None of the Above
Status at the time of application:

I will graduate in May 2021 I will be an incoming freshman graduating high school prior to 2021 I am a GED graduate with no college credit hours
Are you a first generation college student ?

Yes, I am the first among my parents to attend college. No, either my parents have attended college.
Area of Study:
What is your Career Objective:

0/300
Have you submitted an application for college admission?

Yes No
II. High School Information:
Are you or will you be a 2021 high school graduate?

Yes No
High School Attended:
Year of High School Graduation or GED:
Most recent cumulative GPA:
High School activities, community activities, volunteer work, honors, employment, offices held:
III. Extras:
Have you ever received a scholarship at any other organization?

Yes No
Do you plan to complete your two-year degree first?

Yes No
Do you plan to transfer to another college and complete a 4-year degree?

Yes No
Are you a GED recipient?

Yes No
Were you born outside the USA?

Yes No
If so, what country?
Were your parents born outside the USA?

Yes No
If so, what country?
Will you be working while attending College? *

Yes No
If so, will you work:

Full-time Part-time
Please check if you or any of your family work for any of the following organizations:

Equality Nevada Henderson Equality Center
IV. Essay
Your essay should be 300-500 words. You should address in your essay: your college goals and choice of major, what you intend to do with your education, and why a scholarship is important to you. Include any academic and non-academic accomplishments, personal characteristics, or experiences that make you uniquely worthy of scholarship consideration.
Essay:

0/500
Optional Addendum: (Please describe any circumstances or challenges you have overcome and would like us to consider).
V. Documents to Upload
High School Transcripts (Unofficial):

Browse Files

Cancel of
Reference Letter: (Can be mailed to us)

Browse Files

Cancel of
College Acceptance Letter: (If not available, one will be needed to be sent as soon as possible)

Browse Files

Cancel of
Any additional financial documents to be consider:

Browse Files

Cancel of
VI. Applicant's E-Signature
By signing (typing your legal name) in the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.
E-Signature: *
Henderson Equality Center is committed to equal opportunity in employment and education. Equality Nevada does not discriminate in any program or activity on the basis of race, color, religion, gender, age, national origin, disability, marital status, or any other protected class.
Should be Empty:

Now create your own Jotform - It's free! Create your own Jotform

Scholarship Application Form

I. Personal Data:

II. High School Information:

III. Extras:

IV. Essay

V. Documents to Upload

VI. Applicant's E-Signature