Semiquin Scholarship Application

America250PA Semiquin Scholarship Application

America250PA recommends you DO NOT use the JotForm save application function. We have had previous applicants lose access to their saved work when using this feature. We recommend drafting your application responses in a separate Word or Google Doc file, and then copying/pasting your answers into the application form when you are ready to submit.
Student Name*

First NameLast Name
Student Email*
example@example.com
Student Phone Number*
Please enter a valid phone number.
Parent 1 Name*

First NameLast Name
Parent 2 Name

First NameLast Name
Parent Email*
example@example.com
Parent Phone Number*
Please enter a valid phone number.
What County do you reside within? *
Name of the High School you attend*
Name of your School District*
High School Address 1*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
High School County*
High School Website*
High School Phone Number*
Please enter a valid phone number.
High School Scholarship Coordinator/Guidance Counselor Name*

First NameLast Name
High School Scholarship Coordinator/Guidance Counselor Email*
example@example.com
Have you already committed to a PA School/University*

YesNo
Please provide the Institution's name*
For the following 3 questions, find your representative districts here - https://www.legis.state.pa.us/cfdocs/legis/home/findyourlegislator/
What Pennsylvania House District do you reside within?*
What Pennsylvania Senate District do you reside within?*
What US Representative District do you reside within?*
Please describe your Extracurricular Activities, including Volunteer & Work activities. Please include the length of time you have participated in each activity. (300 words)*

0/300
Essay Question - 500 Words Maximum

In 1776, when the Declaration of Independence was signed, the idea of citizenship was radically different from what it is today. The founding generation saw citizenship as tied to land ownership, military service, and participation in a new, fragile democracy born from revolution. To be a good citizen in that era often meant fighting for independence, engaging in public discourse, and helping build the foundations of a republic that had never existed before.
In 2026, America will mark its 250th anniversary—a moment to reflect on how far we’ve come and how our responsibilities as citizens have evolved. Today, being a good citizen might look different, but many of the core questions remain the same: What do we owe to each other? What role should individuals play in shaping our country?

As you consider this question, think about how technology, social change, and global challenges have transformed the expectations of citizenship. Then, look back to 1776 and consider what values and duties were emphasized then. Where are the similarities? Where have we changed?
Upload Essay - Please use the following format when naming your Essay Response file for upload - Last Name - First Initial - County of Residence (for example CassidyCDauphin.docx). Citations for any research in your Essay Response are welcome but not required. Please list any citations at the end of your Essay in a consistent format*

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Please attach one (1) Letter of Recommendation*

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America250PA Semiquin Scholarship Application