Scholarship Application Form
Personal Information
Full Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
example@example.com
Phone Number
Please enter a valid phone number.
Education Information
High School Name
Current GPA
Minimum GPA Required is 3.0
College You Attend or Have Been Accepted To
Major or Planned Major
Community Involvement
Community Service
Describe the organization(s) and your role.
Leadership Roles
What leadership roles have you held in school or your community?
Awards and Recognitions
What honors or awards have you received for academic or community work?
Essay or Video Submission
Essay Upload (File Upload – PDF or Word)
Browse Files
Drag and drop files here
Choose a file
Upload your 500-word essay on your community service and why it matters to you.
Cancel
of
Video Upload (File Upload – MP4, MOV, etc.)
Browse Files
Drag and drop files here
Choose a file
Upload a video no longer than 2 minutes documenting your community service.
Cancel
of
Letters of Recommendation
Submit two letters from individuals familiar with your academic or community work.
Letter of Recommendation #1
Browse Files
Drag and drop files here
Choose a file
Upload Letter
Cancel
of
Recommender's Name
First Name
Last Name
Recommender's Email
example@example.com
Recommender's Phone Number
Please enter a valid phone number.
Letter of Recommendation #2
Browse Files
Drag and drop files here
Choose a file
Upload Letter
Cancel
of
Recommender's Name
First Name
Last Name
Recommender's Email
example@example.com
Recommender's Phone Number
Please enter a valid phone number.
Submit
Should be Empty: