The Phoenix Chapter of the Links, Incorporated & The Phoenix Emerald Foundation
Scholarship Program Application- DUE FEBRUARY 28, 2024
Name
*
First Name
Last Name
Permanent Home 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
Date of Birth
*
-
Month
-
Day
Year
Date
Are you a US Citizen?
*
Yes
No
If not, are you a legal US resident?
*
Yes
No
How did you learn about the scholarship program?
*
Please Select
School Announcement
Flyer
Email
Chapter Member
Friend
Other
Race/ethnicity
*
Please Select
Black/ African American
American Indian/Alaska Native
Hispanic/LatinX
Native Hawaiian/ Pacific Islander
Asian
White
Multiracial
I will be able to attend an interview via zoom if requested
*
Yes
No
Parent or Guardian Information
Father/Guardian Name
First Name
Last Name
Occupation
Company/Place of employment
Mother/Guardian Name
First Name
Last Name
Occupation
Company/Place of employment
Number of children in family
blanks
*
Ages of children
blank
*
Annual family income (all sources)
*
Were you eligible for free or reduced lunch during your high school years prior to 2023-24 academic year? If yes, please specify which years.
*
Yes
No
Which years?
*
Are you eligible for a Pell grant?
*
Yes
No
Is your mother, grandmother, or great grandmother a Link?
*
Yes
No
For High School Applicants
Official School Name
School Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
School Phone Number
Please enter a valid phone number.
High School graduation date ( month/year)
What college or university do you plan to attend? (If undecided, which schools are you considering?)
Have you been admitted?
Yes
No
Degree sought and college major (if known)
For Continuing College Student Applicants
College Name
Location (City,State)
Year in college
*
Please Select
Freshman
Sophomore
Junior
Senior
5th Year Student
Major (and Minor if applicable)
Credits anticipated in Fall 2024
Expected graduation (MM/YYYY)
Activities/Volunteerism, Awards, Honors
Please list your most important school activities in which you have participated during the past 4 years (e.g. student government, the arts, music, sports, etc). List all community or school related activities you have participated in without pay during the past 4 years.
School Activities
*
Community Activities
*
Note all special awards, honors, and offices held
Work experience
Please describe your work experience during the past 4 years, including paid internships. Please indicate the employer, position, dates of employment, hours worked per week, and amount earned. (hourly or total) Please least each experience separately
Work Experience 1
*
Employer
Position
Hours Worked Per Week
Amount Earned
Dates of Employment
Work Experience 2
*
Employer
Position
Hours Worked Per Week
Amount Earned
Dates of Employment
Work Experience 3
*
Employer
Position
Hours Worked Per Week
Amount Earned
Dates of Employment
Required Essay
Please provide us with a one page essay on the topic : “A College Education: My Key to the 21 Century.” Please explain in detail how you expect your college education will make a difference in your future and your community. Your essay must be 500 words.
*
0/500
Letters of Recommendation
Please submit two letters of recommendation. One from a teacher, counselor, or administrator. One from a person in the community ( ex employer, minister, or other).Please see the letter of recommendation instruction document you may provide to those writing your letter. Important: It is your responsibility to collect each letter of recommendation and include both with your electronic submission of your application.
Review instructions for your letter of recommendation at the document below:
Upload your Letter of Recommendation from a Teacher, Counselor, or Administrator below
*
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Upload your Letter of Recommendation from a Community Member below
*
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Application Checklist
The applicant is responsible for submitting all materials to the Phoenix Chapter of the Links, Incorporated by February 28, 2024 11:59PM EST. All materials must be sent to the Scholarship Program Chair, Michele Halyard, MD, at myhalyard@gmail.com. Incomplete applications, resumes, and additional information sheets not conforming to the required format will not be evaluated. The application becomes complete and valid only when the following materials have been submitted:
*
Student application, inclusive of essay
School Official Transcript(s) of grades, including grading scale.Official transcripts may be emailed directly from the high school to email address above or may be forwarded as a hard copy to: The Phoenix Chapter of the Links, Incorporated C/O Scholarship Committee PO Box 67237 Phoenix, AZ 85082
Two letters of recommendation addressing questions included in instruction document
Certification
The Phoenix Chapter of the Links, Incorporated Scholarship Program is supported by the Phoenix Emerald Foundation, Incorporated, a 501(c)3 organization. The Phoenix Chapter of the Links, Incorporated has the sole responsibility for selecting recipients. This application becomes the property of the Phoenix Chapter of the Links, Incorporated. It is recommended that you keep a copy for your file. The Phoenix Chapter of the Links, Incorporated, will not be responsible for lost, late or misdirected, mutilated, incomplete, illegible or postage-due mail. I acknowledge decisions of The Phoenix Chapter of the Links, Incorporated are final. I certify that I meet the basic eligibility requirements of the Scholarship Program, and that the information provided is complete and accurate to the best of my knowledge. If requested, I agree to provide proof of information I have given on this form. Falsification of information may result in termination of any scholarship granted.
Applicant Signature
*
Parental Signature ( if high school applicant)
Submit
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