Hawaii Leadership Residency Scholarship

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Application ID

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As the program has limited resources, we cannot give to everyone who has need and have to decide based on the highest level of impact. Please describe your need honestly so that we can best assess the situation.

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Full Name

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Email

example@example.com

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Phone Number

Please enter a valid phone number.

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Birthdate

Date

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How would you best describe YOUR employment situation?

Education

Education and Employed

Employed

Unemployed

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YOUR estimated annual income

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Parent 1 Name

First Name

Last Name

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Parent 2 Name

First Name

Last Name

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How would you best describe your PARENT(s) employment situation?

Two Employed

One Employed

Unemployed

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PARENT(s) estimated annual income

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Please upload supportive documents

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Max. file size: 10.6MB

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What is the total contribution from these other sources?

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Please specify the amount of support being requested?* This field is required.

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Signature

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