Juneteenth Augusta Scholarship Application
Basic Information
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian Name
First Name
Last Name
Parent/Guardian Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Will you be the first person in your family to graduate college?
Yes
No
How did you hear about the Juneteenth Augusta Scholarship? Click all that apply.
Teacher
Student
Counselor
Principal
Neighbor
Social Media
Google
Other
Teacher Information
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
High School Information
High School Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What is your GPA?
Have you taken the SAT?
Yes
No
What was your score?
Have you taken the ACT?
Yes
No
What was your score?
Upload current high school transcript
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School/â Community - Related Activities
Honors and Special Recognition
College/University Information
What is the college/university have you received a Letter of Acceptance and plan to attend?
Upload Letter of Acceptance
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When do you plan to attend?
Fall 2026
Spring 2026
Fall 2027
Spring 2027
What is your anticipated major or minor?
To complete your degree, will you need any student loans?
Yes, I may need private student loans
No, my federal loans are enough
No, I won't need any loans
I'm not sure
Essay Entry
Title of Essay
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Letters of Recommendation
Recommender #1
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Upload Letter of Recommendation #1
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Recommender #2
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Upload Letter of Recommendation #2
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