High School Scholarship Application Form

High School Scholarship Application (2024--2025)

The information provided on this form will be used by the High School Scholarship Committee to select recipients for scholarships. It is important that you give complete details concerning your college/career plans, activities and financial information.
BASIC INFORMATION
Student's Full / Legal Name*

First NameLast Name
Student Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Student Phone Number*

Area CodePhone Number
Student E-mail*
Student Birth Date

MonthDayYear
Gender

PERSONAL DATA:

(optional scholarship identification for specific scholarships)
Ethnic Background (Check all that apply)

African/AmericanAsian/Pacific IslanderHispanicOther
Disability
Elementary School(s) Attended

REFERENCES:

Please list one educator and at least one community person who would recommend you for a scholarship. Please do not list the person who completes a scholarship recommendation for you.
Reference 1 Name (Position,Phone Number)
Reference 2 Name (Position,Phone Number)

SCHOOL / COMMUNITY ACTIVITIES / WORK / EXPERIENCE/SPORTS/AWARDS/ETC:

List name of club, etc. and years of participation. If you volunteered, list the name of organization and the number of hours, weeks and years that you volunteered. If you worked, list the company, hours per week and length of time. Attach an additional sheet or resume if necessary.
School Activities / Offices Held 1: (not sports)
School Activities / Offices Held 2: (not sports)
Community Service / Volunteer Activities 1 (outside of school)
Community Service / Volunteer Activities 2 (outside of school)
Sports Participation 1
Will you be participating in a sport(s) this year?

YesNo
What Sport?
Travel Experience or Unusual Experiences (study abroad, etc.)
School / Community Awards and Honors 1 (no matter how small) Honor Roll,National Honor Society, Girl/Boy Scouts,Student Council, etc.
EMPLOYMENT 1: List past and present work and length of time employed.
EMPLOYMENT 2: List past and present work and length of time employed.

Father/Stepfather/Guardian Name
Father/Stepfather Employer and Occupation
Mother/Stepmother/Guardian Name
Mother/Stepmother Employer and Occupation:
First generation to attend college?

YesNo
Other income that can be used for educational purposes (inheritance, college funds, etc)-do not include home equity, IRA's or other retirement accounts (optional):
Other Income Amount 1:
Other Income Amount 2:

High School Scholarship Application (2024--2025)