Chrysalis Scholarship Application
2025-2026 Academic Year
The Chrysalis Scholarship is available to any student that participated in Chrysalis After-School programs at school sites or as a GirlPower High School Mentor. All Chrysalis After-School alumni pursuing post-secondary training and education are eligible to apply. All applications will be cross-referenced with historical program attendance rosters to confirm past participation.
Name
*
First Name
Middle Name
Last Name
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Email Address
*
Please do not use a school email address.
Alternate Contact (Parent, Guardian, Mentor) Name
*
First Name
Last Name
Alternate Contact Phone Number
*
Alternate Contact Email Address
*
example@example.com
Social Media Handles
(if applicable)
Facebook
Instagram
Twitter
High School Attended
*
High School Graduation Year
*
Institution Attending Fall 2025
*
Planned Major / Course of Study
*
Attendance
*
Full Time
Part-Time
Current GPA
*
Did you participate in a Chrysalis After-School program?
*
Yes
No
Name of school site where you attended a Chrysalis After-School program
Grade(s) in which you participated at the above program
5th
6th
7th
8th
High School
If you attended multiple Chrysalis After-School programs: Name of school site where you attended program (if different from above)
Grade(s) in which you participated at the above program
5th
6th
7th
8th
High School
Name of school site where you attended program (if different from above)
Grade(s) in which you participated at the above program
5th
6th
7th
8th
High School
Did you serve as a GirlPower High School Mentor?
*
Yes
No
How would your life be different if you would not have had the opportunity to participate in a Chrysalis After-School program and/or as a GirlPower high school mentor?
*
Please take time with your answer and include 3-5 sentences. One sentence answers will not be considered.
Please answer the question using 200 words or less:
0/200
Signature
*
Date
*
-
Month
-
Day
Year
Please upload a close-up head and shoulders photo.
Image Upload
*
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*
I grant the Chrysalis Foundation permission to use this photo for marketing and communications purposes.
With any questions: Please contact Brooke Findley, Senior Director of Strategy and Impact, bfindley@chrysalisfdn.org
Applications are due by May 16, 2025. Average scholarship awards vary between $100-$500. Scholarship award decisions will be communicated in late June 2025. Funds will be distributed directly to education institutions in August 2025. Scholars will be recognized at a Reception scheduled for July 23, 2025. Reception attendance is not required for Scholarship Award.
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