Just One Women's Circle Scholarship Application
Name
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Date of Birth
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Educational Information
Name of High School Attended
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Year Graduated
Ranking in Graduation Class
Date Expected to Graduate
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Academic awards and/or honors you received in High School
Are you a member of any organization in your school? Please provide information
If you have a GED Certificate for High School Equivalency, please provide the information below:
Date received GED Certification
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Upload here your GED information
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Are you a member of any organization outside your school? Please provide information
If you are a transferree from another college or university, please fill out the fields below:
Name of College Last Attended
Academic Year Last Attended
Please provide any academic achievements or awards you have received in College (if there is any)
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Parental Information
Name of Mother or Guardian
First Name
Last Name
Mother's Job/Position
Address of Mother
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of Father
First Name
Last Name
Father's Job/Position
Address of Father (if not the same as above)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Supporting Documents
Transcript (3.5 GPA or Better)
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SAT/ACT Score
Acceptance Letter
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2 Reference Letters (non-family Member)
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EssayEssay Prompt( 1,000 words): Reflect on a time when you questioned or challenged a belief or idea. What prompted your thinking? What was the outcome?
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I CERTIFY THAT ALL STATEMENTS OR INFORMATION I HAVE PROVIDED ABOVE ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. ANY DELIBERATE MISREPRESENTATION FOUND IN THIS APPLICATION MAY BE CAUSE FOR THE APPROVAL OF THIS APPLICATION AND MAY PROHIBIT ME FROM APPLYING AGAIN IN THE FUTURE.
Applicant's Signature
Name of Applicant
First Name
Last Name
Date Signed by Applicant
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
Should be Empty: