Scholars Support Application Fall 2026

Name

First NameLast Name

Preferred Pronouns

Phone Number

Format: (000) 000-0000.

Personal Email

College of DuPage Student Email

Address

Street Address

Street Address Line 2

CityState

Zip Code

Date of Birth:

How did you hear about this Assistance League Scholarship? Select all that apply:

Other

Which Assistance League partner agency referred you:

List All High Schools Attended:

High School Name, City, State

Year of High School Graduation or General Education Diploma:

(YYYY)

Higher Education - List all post-secondary institutions attended beginning with the program in which you are currently enrolled or were most recently enrolled (If you have not attended a post-secondary program enter "None" in the first row):

Rows	Institution	Course of Study/Certificate Program	Dates Attended	Credits Completed	Degree/Certificate Earned
1.
2.
3.
4.

What degree or certificate program are you currently enrolled in, or planning to enroll in, at College of DuPage?

What semesters are you planning to enroll in during the 2026-2027 academic year? Check all that apply.

Total Credit Hours still needed to complete your current COD degree/certificate program:

Total Credit Hours you will need to complete the COD degree/certificate program that you plan to enroll in:

List any honors awarded:

List any extracurricular activities, including volunteer work:

College of DuPage Transcript (may be unofficial):

Employment History - List your last four jobs starting with your current or most recent employer. (If you have not been employed, please enter "None" in the first line.)

Rows	Employer	Job Title	Beginning Date	Ending Date	Hours Worked per Week
1.
2.
3.
4.

Personal Income:

Are you providing financial support to others?

Explain who you are providing financial support to, and the type of support:

Number of dependents claimed on your most recent tax return (not counting yourself): (If you did not file a tax return, enter 0)

How are you paying or planning to pay for your education? Check all that apply

Provide details of any support you receive:

Total Amount of Outstanding Student Loans:

(Enter $0 if you have no outstanding student loans)

Submit your FAFSA Submission Summary Report (not your application) showing your Student Aid Index (SAI) score and the Financial Aid for which you are eligible. If you have any questions, contact scholarship@alcw.org.

Submit your Financial Aid Award Letter from COD. If you have any questions, please contact scholarship@alcw.org.

If you are currently enrolled at COD, then at least one reference must be a COD instructor for a course you have taken.
If you are not currently enrolled at COD, please provide the contact information for a work supervisor or a caseworker.
We will contact the person/s to request a reference but you should also contact them to let them know that they will be receiving an email from Assistance League and request that they provide a reference in a timely manner.

NOTE: We will not be able to award you a scholarship without at least one reference.

Reference 1 Name:

First NameLast Name

Reference 1 Job Title:

Reference 1 Email Address:

Must be a COD email address or other work email address. It may not be a personal email address.

Reference 1 is:

Other

Reference 2 Name:

First NameLast Name

Reference 2 Job Title:

Reference 2 Email Address:

Reference 2 is:

Other

The essay is an important part of the scholarship application. This is a time to boast about yourself. Write a 250-500 word detailed essay that tells your story about why you should be selected to receive a scholarship. We are looking for evidence of your commitment to your program of study and future career. We are interested in understanding how our scholarship would significantly enhance your chances of completing your program and advancing in your chosen field.

Describe how a scholarship will help you personally as an individual to achieve your goals.
Describe your educational and career goals.
Describe anything that may be unique or special about yourself such as accomplishments, family situations, work or volunteer experiences.
Describe any hardships, challenges or obstacles you are facing or have faced.
Write this essay in your own words, as our aim is to learn more about you rather than evaluate the quality of your writing.

0/500

I certify that all information provided in this application is true and correct to the best of my knowledge.

Date

Assistance League may take and publish photographs of me in print and on electronic media for any Assistance League purpose. This includes but is not limited to the Assistance League Chicagoland West website (www.alcw.org), social media, and any other informational or promotional materials. I hereby waive and release for myself all claims for any compensation for such use of pictures, and I hereby indemnify and hold the above organization harmless against any and all claims or damages arising out of use of my pictures or name.

I agree to allow Assistance League Chicagoland West to use excerpts from my essay for use in informational and promotional materials. I understand that such excerpts will be posted anonymously--my name will not be used.

Signature

Date

Scholarship Application

Personal Information

Education

Employment and Financial Information

Required Reference(s)

Essay

Signature and Consent Form

Photo Consent