SCHOLARSHIP APPLICATION, Due March 31, 2023, 4 pm

Student Name*

First NameLast Name

Email - PERSONAL, not your school email.*

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

I am a resident of the following county or city*

Parent(s) or Guardian(s) Name(s)*

First NameLast Name

Parent/Guardian Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Parent/Guardian Phone Number*

Please enter a valid phone number.

Parent/Guardian Email*

example@example.com

I plan to attend*

Name of Institution*

Planned Course of Study*

I am a 2023 Graduating Senior from*

Your current six (6) semester grade point average (GPA) must be a 2.75 or higher on a 4.0 scale (or its equivalent). What is your current six (6) semester GPA?*

Upload your official transcript, which must be signed by the high school guidance counselor, showing your GPA and all high school grades*

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I understand that by submitting this signed document, I will be a candidate for a scholarship from the Rising Sun Regional Foundation. IF I am selected, I agree to the following:

1. I agree to furnish proof of my acceptance and enrollment in an institution accredited for higher education.

2. I agree to utilize this grant at the institution so stated by me in this application or I will consult with the Rising Sun Regional Foundation regarding any proposed change.

3. I understand that I must use said funds within one calendar year from the date of the award or any unused balance will be forfeited.

4. I understand that the award may be used for tuition, books, room and board, or student fees, and that I will first apply said funds toward any outstanding tuition and book expenses.

5. I hereby specifically waive any confidentiality which might otherwise be involved and freely consent to said institution furnishing any and all scholastic information regarding me which it may at any time have in its file or on record.

Date*

Date

Signature*

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RISING SUN REGIONAL FOUNDATION