2022-2023 ASALH Scholarship Application

ASALH Scholarship Application

Applications are being accepted until February 15th.
Founders of Black History Month

ASALH: Association for the Study of African American Life and History

ASALH Manasota Branch, Ernestine Harris, Chartering President

asalh-manasotafl.org

The Manasota ASALH Scholarship Program was initiated in 1997. One of the goals of the organization is to support Black youth in the pursuit of their educational aspirations. The awarding of this scholarship is a step in that direction.

ELIGIBILITY: Before you proceed with this application please determine if you qualify to apply and if you have all of the following proper documentation.
The application process may be saved, but you will not be able to submit without all required fields completed. (*)

• Must be a graduating Black high school student who has been admitted to and enrolled in an accredited four (4) year college or university upon receiving the award.

• Must possess a cumulative grade point average of 3.0 or higher on a 4.0 scale.

• Must include a recent photo, copy of high school transcript, FAFSA Form.

REFERENCES
• Must provide three (3) letters of recommendation from non-family members with at least one current from your school. Letters must include addresses and telephone numbers of persons providing the reference.

INTERVIEW
• Must meet with the Scholarship Committee at agreed interview time prior to final award.

Begin ASALH Scholarship Application
1. Name *

First Name Last Name
2. Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
3. Cell Phone Number *

Area Code Phone Number
Home Phone Number *

Area Code Phone Number
4. Email *
example@example.com
5. Date of Birth *

Month Day Year
Date
Place of Birth *
City, State. Country
6. List First and Last Names of Parents/Guardians *
7. Current School Attending *
Current School Phone Number *

Area Code Phone Number
Current School Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
8. List the Colleges to which you have applied. *
9. List the Colleges to which you have been accepted. *
What is your planned major? *
10. What financial role will your family play in supporting your education? *
11. How would you describe your leadership abilities with any involvement in clubs, activities, sports, honors, and or awards? *
12. Describe your work experiences if any. *
13. Describe your extracurricular activities & community service and include # of hours *
14. Write “YOUR BIO” in 300 words or less including and describing any additional club and sports activities, awards, honors as well as your intended major and career aspirations. *

0/300
15. Recent Photo *

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16. Copy of HS Transcript *

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Cancel of
17. Entire FAFSA Form *

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18. Two (2) Non-Family Letter of References *

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Both letters must include addresses and telephone numbers of persons providing the reference. Cancel of
19. At least one (1) School Current Letter of Reference *

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Letter must include addresses and telephone numbers of persons providing the reference. Cancel of
20. Media Disclosure: Submitting this application and if successful in receiving a scholarship, I agree that my information including photo may be sent to news outlets to showcase the achievements of local students.
21. Student Signature *

Use mouse or keypad to sign (for smart devices use your finger). Clear
22. Parent/Guardian Signature *

Use mouse or keypad to sign (for smart devices use your finger). Clear
CHECKLIST Before Submitting Application *

Application Form Fully Completed References(3) Photo Copyof HS Transcript FAFSA Form
Please note in order to submit your application all required fields (*) must be completed first.

If you have any questions please contact

Mrs. Harriet A. Cowan, Scholarship Chair, Manasota ASALH, Inc.
hcowan4521@aol.com
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ASALH Scholarship Application

Begin ASALH Scholarship Application