Chrysalis Scholarship Application
2021-2022 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 applications will be cross-referenced with historical program attendance rosters to confirm past participation.
Street Address Line 2
State / Province
Postal / Zip Code
Alternate Contact (Parent, Guardian, Mentor) Name
Alternate Contact Phone Number
Social Media Handles
High School Attended
High School Graduation Year
Institution Attending Fall 2021
Did you participate in a Chrysalis After-School program?
School Site/Location of program(s) attended:
Grade(s) in which you participated
Did you serve as a GirlPower High School Mentor
How would your life be different if you would not have had the opportunity to participate in Chrysalis After-School?
Please answer the question using 200 words or less:
With any questions: Please contact Brooke Findley, Director of Community Initiatives and Investments, email@example.com
Applications are due by April 30, 2021. Awards announced by May 22, 2021.
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