JEDI Scholarship Program
Application Form
All fields marked with * are required and must be filled.
Scholarship Category*
Please Select
Diversity and Inclusion
Under-Resourced Population
Ethnicity*
Prefer Not to Answer
American Indian or Alaska Native
Asian
Black or African American
Hispanic
Native Hawaiian or other Pacific Islander
White
Not Listed
With which gender identity do you most identify?*
Woman
Man
Transgender Woman
Transgender Man
Non-Binary
Agender/I don't identify with any gender
Gender not listed
Prefer not to state
Name*
First Name
Last Name
Preferred Pronouns
she/her/hers
he/him/his
they/them/theirs
ze/zir/zirs
not listed
Email*
example@example.com
Daytime Phone Number*
Please enter a valid phone number.
Address*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Degrees/Credentials Designation*
Eligibility Requirements Information
Hold a bachelor's Degree or higher at the time of application or demonstrate equivalent experience (either paid or volunteer). Equivalent experience must be documented and cite as many of PACB's Knowledge, Skill, and Ability statements as are applicable.
Select an Eligibility Pathway
Education - Means you hold a Bachelor's Degree or higher.
Equivalent Experience - This means you can demonstrate paid or volunteer experience.
Upload applicable documentation of Eligibility
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PACB's Knowledge, Skill, and Ability Statements are available at: https://www.pacboard.org/wp-content/uploads/KSA-Statements-Download.pdf
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