2024-2025 Scholarship Application
Applications must be submitted by March 1, 2024
Name
*
First Name
Middle Name
Last Name
Home Address
*
Street Address
Street Address Line 2
City
State
Postal / Zip Code
Cell Phone
*
Please enter a valid phone number.
Email Address
*
example@example.com
Parent Email Address
*
example@example.com
High School you currently attend:
Name of High School Counselor
First Name
Last Name
Mother's Name
First Name
Last Name
Mother's Address
Street Address
City
State
Postal / Zip Code
Mother's Occupation and Employer
Occupation
Employer
Father's Name
First Name
Last Name
Father's Address
Street Address
Street Address Line 2
City
State
Postal / Zip Code
Father's Occupation and Employer
Occupation
Employer
Current GPA
*
0.00-4.00 scale
Highest Composite ACT or SAT Score
*
College/University you plan to attend in the 2024-2025 Academic Year
*
Proposed Major/ Field of Study
*
Total number of dependents in your family
*
1
2
3
4
5
6+
Total number of dependents who will be enrolling in college in 2024
*
1
2
3
4
5
6+
Please indicate your family income for last year's Federal Tax Return
*
$0-$25,000
$25,000-$50,000
$50,000-$75,000
$75,000-$100,000
$100,000-$200,000
$200,000+
Have you received any other scholarships at this time?
*
Yes
No
If yes, please list the name of the scholarship, and the amount awarded.
Please explain any circumstances or challenges you or your family have experienced that will make paying for college a hardship for you.
Volunteer/Community Service: Please provide details of the activities you participated in and the duration of your involvement in any volunteer work or community service.
*
Academic Honors/Awards: Please list all high school honors/awards you have received.
Clubs/Extracurricular Activities: Please list any participation and offices held.
Other: Please list any additional special recognition(s) you have received.
Future Career/ Educational Goals:
*
Essay Upload: The Junior Auxiliary of Hattiesburg is a service organization founded on the principles of helping children and assuming leadership roles in meeting the needs of our community. Please provide an original, self-written, detailed statement of 250 words or less describing a service project in which you took the lead or actively participated, along with the valuable insights or benefits you gained from that experience. **The committee will only consider the first 250 words**
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Letter of Recommendation #1
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Letter of Recommendation #2
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Copy of High School Transcript (9th grade- present) including ACT/SAT scores
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I confirm that I am the sole author of the enclosed essay and that all information provided in this application is truthful and precise. I am aware that is any of the information I have provided is found to be false, it may result in the withdrawal of the scholarship offer
*
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