ICON Foundation Scholarship Application
2025
Legal Name
*
First Name
Last Name
Preferred Name
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
I give permission for my name as indicated to be utilized in publications, social media and in print:
*
YES
NO
I give permission for my photo as indicated to be utilized in publications, social media and in print:
*
YES
NO
I Will be attending the award ceremonies on Friday, June 13, 2025 at The Verdict, 1901 Harney Street, Omaha, NE 68102. Event starts at 7:00pm.
*
YES
NO
Proof of Nebraska or Southwest Iowa residency
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Letter of acceptance from a higher learning institue
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
A letter self identifying as a member of the GLBTQ+ community OR the child of a member of the GLBTQ+ community
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
A personal statement that includes personal history and description of any community service or involvement as well as a detailed plan describing your higher education goals
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Letters of recommendation from three (3) professional persons not related to you. At least one (1) of these letters must be from a person who self-identifies as a GLBTQ+ person. (LETTER 1)
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Letters of recommendation from three (3) professional persons not related to you. At least one (1) of these letters must be from a person who self-identifies as a GLBTQ+ person. (LETTER 2)
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Letters of recommendation from three (3) professional persons not related to you. At least one (1) of these letters must be from a person who self-identifies as a GLBTQ+ person. (LETTER 3)
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
A statement of financial need
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
By signing below, I declare that the information I have furnished is truthful and correct. I also hereby acknowledge that I am of the GLBTQ+ community or that my parent(s) are of the GLBTQ+ community
*
Submit Your Application
Clear All Questions
Should be Empty: