Mustard Seed Scholarship Application

Mustard Seed Scholarship Application
We offer scholarships of up to $200 for students committed to participating in extracurricular activities, both in school and outside of it.

Read and follow the instructions carefully prior to submitting your application.
If selected, you will be asked for documentation to support the data you provide. Likewise, all correspondence and award agreements will be generated from the personal information submitted below. So, please use proper spelling, capitalization and punctuation.
Personal Data

Tell us about yourself
Full Name*

First NameLast Name
Birthdate*

MonthDayYear
Mobile *
Email *
Where the confirmation will be send to
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent or Guardian's Full Name*

First NameLast Name
Parent or Guardian's Mobile *
Parent or Guardian's Email *
Where the confirmation will be sent to
Please check your status at the time of application.*

I am a Rising 6th GraderI am in Middle School (6th - 8th)I am in Highschool (9th-12th)
Gender

MaleFemale
Extracurricular Program Information
School/Program/Organization Name*
Name of program director (E.g. coach, instructor)*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
What is your extracurricular activity? (E.g. sports, band, outside of school options, dance)*

0/300
How long have you been involved in this activity?*

0/300
250-350 word short essay discussing ways extracurricular activities fostered a sense of accountability and responsibility in you, taught you how to express yourself, and taught you skills that have become useful in school life and day-to-day activities.*
How much is the full tuition amount? amount*
Have you paid any amount yet for this activity?*

YesNo
If you have made a payment towards your tuition or dues, please indicate the amount paid. amount*
By applying for this scholarship, you are pledging to dedicate a minimum of 10 service hours within the year if chosen. This commitment involves volunteering your time to an organization of your choice. Further information regarding available opportunities will be provided to you. Do you agree to this requirement?*

YesNo
Do you have any questions or concerns?
All applicants will be required to submit a letter of recommendation from a teacher, mentor, pastor, leader and/or any influential adult in your life.
Letter of Recommendation
Letters of recommendation allow us a glimpse of your character as a person, student, and community member. These letters do not necessarily need to come from a teacher; they can be written by anyone in your life, such as a family member, church leader, or community member—essentially, anyone who can help us understand who you truly are!

All letters of recommendation should be emailed to: scholarship@gracedplace.org. Or call for any addition questions or concerns @ 404-287-5335
Upload Recommendation Letter*

Cancelof
Applicant's E-Signature
By signing the space below, you are certifying that all information is correct and that you are the person(parent) completing this application. When you press the submit button, you will receive an email confirmation that your application was received.
Signature*

Powered by Jotform SignClear
GRACED PLACE FOUNDATION INC. Committed to equal opportunity in employment and education. The Organization does not discriminate in any program or activity on the basis of race, color, religion, gender, age, national origin, disability, marital status, or any other protected class.
Should be Empty:

Mustard Seed Scholarship Application

Personal Data

Extracurricular Program Information

Letter of Recommendation

Applicant's E-Signature