Joi's Angels Community Service Scholarship Application Form

Youth Community Service

Scholarship Application Form
I. Personal Data:

Tell us about yourself
Full Name *

First Name Last Name
Birthdate: *

Month Day Year
Mobile No. : *

Area Code Phone Number
E-mail : *
Where the confirmation will be send to
Home Address : *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Optional Informations : Information regarding gender, ethnic origin and race are optional. The information is requested for post-scholarship report generation only and in no way affects your selection for college scholarship awards. However, providing this information may increase your opportunities for scholarships where donors have asked that priority consideration be given to students meeting certain demographic criteria (such as minority status, parent's place of employment, area of study, etc.)
Gender:

Male Female
Are you a US citizen?

Yes No
Ethnic Origin:

Hispanic Non-Hispanic Not Indicated
Race? (Choose one or more):

White Black or African American Asian American Indian or Alaskan Native Hawaiian or Other Pacific Islander Non-Resident Alien
Are you a first generation college student ?

Yes, I am the first among my parents or grandparents to attend college. No, either my parents or grandparents have attended college.
Do you have a disability?

Yes No
Were you born outside the USA?

Yes No
If so, what country?
Were your parents born outside the USA?

Yes No
If so, what country?
II. High School Information:
High School Attended:
Year of High School Graduation or GED:
Most recent cumulative GPA:
School activities, honors, offices held, etc.:
Community activities, volunteer work, honors, offices held:
What is your Career Objective:

0/300
Will you be working while attending college? *

Yes No
If so, will you work:

Full-time Part-time
What college will you attend?
VII. Essay
What does the Joi's Angels mission statement mean to you? How will you embody that mission in college and beyond? (300 - 500 words)
Essay:

0/500
VIII. Applicant's E-Signature
By signing (typing your legal name) in the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.
E-Signature: *
Should be Empty:

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Youth Community Service

I. Personal Data:

II. High School Information:

VII. Essay

VIII. Applicant's E-Signature