Gladys Johnson College Scholarship Application

Gladys Johnson College Scholarship Application

Administered by The Women’s Empowerment Series, Inc. a 501(c)3 Non-Profit organization. Female students must reside in zip codes 19144 or 19119. Application Portal Closes 5/10/2025.
Student’s Full Name*

First NameLast Name
Email*
example@example.com
Mobile Number*

Area CodePhone Number
Home Phone Number*

Area CodePhone Number
Date of Birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
1st Choice: College you plan to attend*
Have you*

AppliedAcceptedOther
2nd Choice: College you plan to attend*
Have you*

AppliedAcceptedOther
What Major/Program are you planning to study*
Choose the Scholarship for which you are applying*
ESSAY: How will the Gladys Johnson College Scholarship assist you & what impact do you anticipate making to the community upon completion of your education. *

0/300
If applying for Classical Music Scholarship, attach a 2 minute video of your talent for review*
Email to: GJScholars@thewomensempowermentseries.org
Academic Information
Grade / Year Level*
Junior Year Cumulative GPA *
Junior Year GPA
Senior Year GPA*
Date Expected to Graduate*

MonthDayYear
Date
Are you a member of any organizations or clubs at your school? Please provide information*
Are you a member of any organization outside your school. Provide organization names : community organizations/clubs/groups/teams)? Include Leadership positions, Service projects/activities.*
Work Experience (if applicable): Include name of business, position and time employed
High School Information
Name of School*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Guidance Counselor Name*
Include 3 letters of recommendation (2 Teachers & 1 Personal: (Church/Volunteer org.) Recommendations must be emailed directly to GJScholars@thewomensempowermentseries.org*
Include Names (with contact information) and Relationship of Recommenders

Parent/Guardian Information
Name of Parent/s or Guardian (person you live with 90% of the time) OR if parents live in different houses, list primary Parent*

First NameLast Name
Phone Number*

Area CodePhone Number
Address of Primary Parent/s or Gaurdian*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employer Information: Name of Company*
Job Title/Position*
Employer Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of Secondary Parent*

First NameLast Name
Secondary Parent’s Job/Position*
Phone Number*

Area CodePhone Number
Address of Secondary Parent (if not the same as above)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Number of children in the family*
Number of children in college*
Family Financial Information
Are you a dependent of your Parents?*

YesNo
Your Family's Annual Income*
Are you living in a Foster Home -If yes, you must answer the following question.*
Name of Agency
Agency Phone Number

Area CodePhone Number
Name of Agency Director
Agency Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Please explain any financial or family circumstances of which you would like the committee to be aware*

BY SIGNING & SUBMITTING THIS APPLICATION, YOU COMMIT TO THE FOLLOWING:
· Must send official letter accepting our Scholarship if you are the chosen recipient

· Must send your official college acceptance letter from the school you have committed to attend

· Must submit letter every year requesting Scholarship renewal along with yearly college transcripts by June 5th (4 years maximum)

· Must maintain cumulative GPA of 3.00 in college every year to maintain receiving Scholarship

I AFFIRM THAT ALL STATEMENTS I HAVE PROVIDED HEREIN ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. ANY MISREPRESENTATION I HAVE MADE CAN CAUSE FOR THE INVALIDATION OF MY APPLICATION AND SHALL BAR ME FROM RE-APPLYING FOR THE SAME.
Applicant's Signature*

Clear
Name of Applicant*

First NameLast Name
Date Signed by Applicant*

MonthDayYear
Date
Should be Empty:

Gladys Johnson College Scholarship Application

Academic Information

High School Information

Parent/Guardian Information

Family Financial Information