Giving Hope & Help Education is Your Passport Scholarship Program Application

NAACP Newburgh/Highland Falls Community Service Icon Scholarship Award Application
The NAACP Newburgh/Highland Falls Community Service Icon Scholarship was started to honor the accomplishments of three African American women - Sadie Tallie, Roxy Royal, and Lillian Howard. These women dedicated their lives to making their community, and surrounding communities, better for everyone. These three $1,000 scholarships will be awarded to deserving seniors who attend Newburgh Free Academy and/or James I. O’Neill High School, will be attending college or a trade school in the fall of 2024, and have shown a commitment to continuing the work of social justice to better their communities.
ATTENTION:

This form may be saved and submitted later. Failure to enter all fields will prevent application submission.

Deadline extended:

Completed applications are due by Friday, June 14, 2024 at 5:00pm.
Qualifications for the NAACP Newburgh/Highland Falls Community Service Icon Scholarship:

• Be a member of the NAACP. If you are not a member of the NAACP, join today (There are some student scholarships available to cover the membership fee)
• Be Black or African American
• Be a graduating high school senior, with a GPA of 2.5+ (75% or above)
• Submit two letters of recommendation from a High School Counselor,
Educational or Community Organization Leader
• Submit a letter of acceptance on official letterhead from an accredited college, university, or trade school (a clear copy of the letter is acceptable)
• Submit Official High school transcript
• Submit a 300-word Essay on a need(s) in your community and how you plan to give back to meet the needs(s) while in college or trade school and beyond to make a difference
STUDENT INFORMATION
Name*

First NameMiddle InitialLast NameSuffix
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Address*
example@example.com
Phone Number*

Area CodePhone Number (000-0000)
PARENT/LEGAL GUARDIAN INFORMATION

If not applicable please fill the text box with "N/A"
Mother's Name (or Guardian) :*

First Name Last NameSuffix
Mother's/Guardian Email Address
example@example.com
Home Telephone Number

Area CodePhone Number
Mobile/Alternate Number*

Area CodePhone Number
Father's Name (or Guardian)*

First NameLast NameSuffix
Father/Guardian Email Address*
example@example.com
Home Telephone Number

Area CodePhone Number
Mobile/Alternate Number*

Area CodePhone Number
SCHOOL INFORMATION
Current High School*
Guidance Counselor's Name*
Guidance Counselor's Phone Number*

Area CodePhone Number
School Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Guidance Counselor's Email*

Confirmation EmailRe-enter the email address
Current Grade Point Average*
Example: 3.0/4.0 scale
Weighted GPA (if applicable)
List of Extracurricular Activities*
Example: Chess Club, Community Service Council, etc.
Community Service/Involvement*
Example: Harvester's Food Packager, MLK Program Volunteer
Scholarships, Honors and Awards Received (if inapplicable please type "None at this time.")*
College/Trade School expected to attended*
Prospective Major or Undecided*
Prospective Minor (if applicable)
Required Documents
High School Transcript*

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Must be the most current transcript from the previous semester Cancelof
College Acceptance Letter

Browse Files

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Recommendation Letter #1*

Browse Files

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Recommendation Letter #2*

Browse Files

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Required Documents (continued)
Essay Question
Please submit a 300 word essay to the proposed question. The submission should be in the format of pds, doc, txt or png.

"What is a need(s) in your community and how do you plan to give back to meet the need(s) while in college/workplace and beyond to make a difference"?
Upload Essay Here*

Upload File
pdf, doc, docx, txt, or png Cancelof
I certify that the information provided in this application is true, complete, and accurate and that all statements and essays are my own work. A scholarship award from the NAACP Newburgh/Highland Falls may be denied or revoked if any information contained herein is found to be untrue.

Should I receive an award, I hereby give permission to the NAACP Newburgh/Highland Falls branch to reproduce the photographs, and/or video images taken of me, or members of my family. For the purpose of publication, promotion, illustration, or advertising, in any manner or in any medium. Furthermore, I grant permission to use my statements that were given during the application process, with or without my name, for the purpose of advertising and publicity without restrictions. I waive my right to: any compensation and to inspect or approve the finished version(s), including written copy that may be created in connection with the photographs.
Signature of Applicant*

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Date*

MonthDayYear
DateHourMinutesAM/PM Option
Date*

MonthDayYear
DateHourMinutesAM/PM Option
Signature of Parent/Guardian*

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NAACP Newburgh/Highland Falls Community Service Icon Scholarship Award Application

STUDENT INFORMATION

PARENT/LEGAL GUARDIAN INFORMATION

SCHOOL INFORMATION

Required Documents

Required Documents (continued)

Essay Question

"What is a need(s) in your community and how do you plan to give back to meet the need(s) while in college/workplace and beyond to make a difference"?