X-Hale Scholarship Application
Name
*
First Name
Last Name
Student E-mail
*
example@example.com
Mobile Number
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Major
*
Ethnicity
*
University
*
Are you a full time student?
*
Yes
No
Do you have a 2.5 GPA or better?
*
Yes
No
How will the X-Hale Scholarship help you?
*
Submit
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