The Phoenix Chapter of the Links, Incorporated & The Phoenix Emerald Foundation

The Phoenix Chapter of the Links, Incorporated & The Phoenix Emerald Foundation

Scholarship Program Application- DUE FEBRUARY 28, 2024
Name*

First NameLast Name
Permanent Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Date of Birth*

MonthDayYear
Date
Are you a US Citizen?*

YesNo
If not, are you a legal US resident?*

YesNo
How did you learn about the scholarship program?*
Race/ethnicity*
I will be able to attend an interview via zoom if requested*

YesNo
Parent or Guardian Information
Father/Guardian Name

First NameLast Name
Occupation
Company/Place of employment
Mother/Guardian Name

First NameLast Name
Occupation
Company/Place of employment
Number of children in family blanks* Ages of childrenblank*
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.*

YesNo
Which years?*
Are you eligible for a Pell grant?*

YesNo
Is your mother, grandmother, or great grandmother a Link?*

YesNo
For High School Applicants
Official School Name
School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
School Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
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?

YesNo
Degree sought and college major (if known)
For Continuing College Student Applicants
College Name
Location (City,State)
Year in college*
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 WeekAmount Earned

Dates of Employment
Work Experience 2*

Employer

Position

Hours Worked Per WeekAmount Earned

Dates of Employment
Work Experience 3*

Employer

Position

Hours Worked Per WeekAmount 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*

Cancelof
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 essaySchool 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 85082Two 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)
Should be Empty:

The Phoenix Chapter of the Links, Incorporated & The Phoenix Emerald Foundation

Parent or Guardian Information

For High School Applicants

For Continuing College Student Applicants

Activities/Volunteerism, Awards, Honors

Work experience

Required Essay

Letters of Recommendation

Application Checklist

Certification