Jay Bloomer FoundationScholarship

Jay Bloomer Foundation Scholarship Application
Before completing this application, please be sure you have read the full eligibility requirements .

Reminders:
- This scholarship is only for students graduating from TL Hanna High School or Dobyns-Bennet High School.
- Applicants should exhibit many of the following qualities:
  - Dedication to academic performance
  - Athletic participation and achievement
  - Leadership among peers
  - Concern for the Community
  - Well-rounded and good-natured; charismatic
  - A strong and demonstrated work-ethic
- You will need your SAT/ACT scores and class rank for this application.
- You will also be asked to upload the following documents as part of this application:
  - Personal narrative essay
  - Letter of recommendation (minimum of 1 required)
  - Official transcript
  - Letter of Acceptance from the educational institution
You are able to begin the application, save it, and return to it as needed.
Name*

First NameLast Name
High School Graduation Year*
What high school are you graduating from?*

T.L. Hanna High SchoolDobyns-Bennett High SchoolOther
We're sorry. This scholarship is only available to students graduating from T.L. Hanna High School or Dobyns-Bennett High School.
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Father's Name*

First NameLast Name
Mother's Name*

First NameLast Name
What are your plans for the future?*
Extracurricular activities/honors:*
What college do you plan to attend?
What do you plan to major in?
Class Rank*
Please put your rank/total number in your class.
GPA*
Please put your GPA/highest possible GPA at your school.
Please enter at least one of the following test scores:*

SAT ACT

SCORE
Please upload a copy of your official high school transcript.*

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Please upload at least one letter of reference.*

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Please upload a copy of the letter of acceptance from the college you plan to attend.*

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Please upload your personal narrative, including a statement on financial need and your interest in community service.*

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Use your mouse or finger to draw you signature below.*

Clear
By initialing here I indicate that all information provided in this application, including uploaded attachments, is truthful to the best of my ability.initials
Should be Empty:

Jay Bloomer Foundation Scholarship Application