Autism Alliance of Northeastern NY Scholarship Application

Autism Alliance of Northeastern NY Scholarship Application
Deadline to apply: July 31, 2026

The Autism Alliance of Northeastern NY will award up to four $1,000 scholarships to eligible autistic students. ($500 for part-time students.) Past recipients may reapply.

Applicants must meet the following criteria:
- Have an autism diagnosis
- Have a permanent address within Clinton, Franklin, or Essex County. Students may attend school outside of these counties, provided that they maintain a permanent address within the tri-county area
- Have been accepted into a post-secondary program (such as college, university, trade school, or vocational training or educational program)
- Demonstrate financial need
Please upload the following documents within the form (if reapplying, you do not need to resend proof of diagnosis and acceptance letter, however, please upload another letter of recommendation):
- Proof of autism diagnosis
- Acceptance letter from the educational institute you plan to attend
- Letter of Recommendation from a teacher, guidance counselor, or other school official
Scholarship funds will be awarded directly to the educational institution of the recipient for use toward tuition, books, or other educational expenses.

Please email grants@aaneny.org if you have any questions or issues with this form.
Email
example@example.com

About You

Please complete the questions below.
Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Mailing Address

Street Address

Street Address Line

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number

Family Income

Please include all sources such as wages, Social Security, retirement, pension, disability etc.
Household Income
Are you financially independent? This means that you financially support yourself.
If yes, please explain.

Education

Please complete the questions below.
Name of High School
Graduation Date

MonthDayYear
Date
Name of College or Trade School
Major or Trade
Cost per Year
Type of Enrollment

Financial Need and Essay

Please complete the questions below.
What are the circumstances that make financial assistance necessary?
Have you previously received a scholarship from the Autism Alliance of Northeastern NY?
Essay: Please describe in 300 to 500 words your educational goals, how a scholarship will help in achieving these goals, and the unique perspectives or experiences you have as an autistic individual. (Alternatively, you may upload a video essay to the file submission below.)
Is there anything else you would like us to know
Video Essay

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File Upload

Please upload the following required documents. If reapplying, you do not have to upload Proof of Autism Diagnosis or Acceptance Letter.
Proof of Autism Diagnosis

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Acceptance Letter

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Letter of Recommendation

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By signing my full name below, I confirm the information provided is accurate. I understand that any falsification would disqualify this application.
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