2023 Mandarino Scholarship
Please fill out all pages of the application.
Student Name
First Name
Last Name
Student Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Student Email
example@example.com
Student Phone Number
Please enter a valid phone number.
Date of Birth
-
Month
-
Day
Year
Date
Student ID
High School, Trade School or College
Address of High School or College
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Expected Graduation Date
-
Month
-
Day
Year
Date
Number in High School Graduating Class
GPA
Honors & Awards (please list chronologically and detail honors received)
Participation in extracurricular activities, class, and school organizations (offices held, awards, etc). Please list chronologically and give dates.
Personal and community (including employment) activities conducted outside of school. Please list chronologically and give dates.
Miscellaneous - Other activities such as special interest, hobbies, or additional information relevant to activities; plans for college study - please identify major academic interests which you will pursue at the college level. If possible, please indicate your career plans.
Please list other scholarships applied for, and identify those which you have been awarded.
Colleges applied to in order of preference (NA if currently college enrolled)
Prospective Major
Course Duration
Education History: Describe in narrative form, not to exceed 200 words, the development of your educational interests from the time of entry to high school until the date of this application.
Names and ages of dependent children in household
List financial obligations (tuition, fees, room and board) now being incurred by other members of the family.
Educational status of children at the time of this application.
Please upload a photo of the student's school identification.
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The information submitted on this form and attached hereto has been examined by me and I herby certify that the acts herein are true.
Signature Date
-
Month
-
Day
Year
Date
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Uploads Required
Proof of Current Candidate Status: Transcript (showing rank in class), post secondary enrollment, or trade school enrollment
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Two (2) Letters of Recommendation (neither over 200 words - one from a school official and one from a member of the community)
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Letter 1
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2nd Letter of Recommendation
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Letter 2
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Student ID, school name, mailing address, and account information (so that scholarship funds may be mailed to the school and applied directly to recipient's account)
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Student Budget: Please download the proposed student budget from the PHHA website, fill out, and upload here.
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To Be Completed by Parents or Guardians
Father (or guardian)
First Name
Last Name
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Father (or guardian) employer
Employer type of business
Position
Years with employer
Annual Salary (before taxes)
Other income
Mother (or guardian)
First Name
Last Name
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mother (or guardian) employer
Employer type of business
Position
Years with employer
Annual Salary (before taxes)
Other income
Explain any extraordinary expenses or indebtedness
Copy of Parent/Guardian PA Racing License
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Parent/Guardian Budget: Please download the proposed parent/guardian budget from the PHHA website, fill out, and upload here.
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Please submit your current tax return.
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Submit
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