Simple Scholarship Application Template

Scholarship Application Form
I. Personal Data:

Tell us about yourself
Full Name*

PrefixFirst NameMiddle NameLast NameSuffix
Birthdate:*

MonthDayYear
E-mail :*
Where the confirmation will be send to
Home Address :*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Gender:

MaleFemale
Are you a US citizen?

YesNo
Are you a first generation college student ?

Yes, I am the first among my parents or grandparents to attend college.No, either my parents or grandparents have attended college.
II. High School Information:
Will you be a May 2019 high school graduate?

YesNo
High School Attended:
Year of High School Graduation or GED:
High School activities, community activities, volunteer work, honors, offices held:
III. ACT Information:
ACT composite (overall) score?
VI. Extras:
Please check each of the qualifiers below that apply to you. This data may increase your likelihood of qualifying for the scholarship.
College that you plan to attend
Have you received other scholarships?

YesNo
If you answered yes, please indicate the amount of scholarship money that you will receive. Check all that apply

$500 or less$500-$1500partial tuitionfull tuitionfull tuition, room and board, and booksother
Do you qualifiy for a pell grant?

YesNo
Do you qualify for financial aid?

YesNo
Please indicate which varsity sports that you participated in during high school.

FootballBasketballBaseballSoftball
Please indicate any sports that you will participate in college.

FootballBasketballBaseballSoftball
VII. Essay
Your essay should be 300-500 words. You should address in your essay: your college goals and choice of major, what you intend to do with your education, and why a scholarship is important to you. Include any academic and non-academic accomplishments, personal characteristics, or experiences that make you uniquely worthy of scholarship consideration.
Essay:

0/500
VIII. Applicant's E-Signature
E-Signature:*
Should be Empty:

Scholarship Application Form

I. Personal Data:

II. High School Information:

III. ACT Information:

VI. Extras:

VII. Essay

VIII. Applicant's E-Signature