Dr. Harry Demirgian Memorial College Scholarship
APPLICATION DEADLINE: JUNE 15
Name
*
First Name
Last Name
Middle Name:
Date
*
-
Month
-
Day
Year
Date
Birthplace:
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Mother's Full Name:
*
First Name
Last Name
Father's Full Name:
*
First Name
Last Name
Current Residence Information
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Primary Residence Information
If different from above
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Guardian Residence Information
If different from above
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Enrollment History
High School Attended
School Name
*
Major(s)
*
Date Started
*
-
Month
-
Day
Year
Date
Date Ended
*
-
Month
-
Day
Year
Date
Anticipated Grade Level in September
Undergraduates
Sophomore
Junior
Senior
School Name
*
Graduates
1st Year
2nd Year
3rd Year
4th Year
School Name
*
PLEASE PROVIDE INFORMATION ABOUT YOUR MAJOR(S), YOUR INTENDED DEGREE, WHEN YOU EXPECT IT WILL BE AWARDED, AND ANY OTHER PERTINENT INFORMATION.
*
HONORS, AWARDS, SCHOLARSHIPS RECEIVED
*
EXTRACURRICULAR ACTIVITIES AND INVOLVEMENT IN ORGANIZATIONS (INCLUDE DESCRIPTION OF EACH, AND YOUR PARTICIPATION)
*
INTERNSHIPS (INCLUDE DATES AND ORGANIZATIONS)
*
Applicant's Employment
Are You Currently Employed?
*
Yes
No
If so, how many hours per week?
Employer (current or last)
Years Employed
Employer's Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Position
Salary (gross income)
Name of Supervisor
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Financial Information
Yearly Tuition Amount
*
Yearly Living Expenses
*
Your Estimated Annual Income
*
Your Estimated Family Contribution
*
Father's Occupation
*
Annual Income
*
Mother's Occupation
*
Annual Income
*
Parent's Address (if different from applicant
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Housing Status
*
Own
Rent
IN THE SPACE BELOW, PLEASE LIST IN DETAIL ANY GRANTS AND/OR SCHOLARSHIPS OR LOANS YOU HAVE RECEIVED DURING YOUR UNIVERSITY EDUCATION. PLEASE DISCLOSE THE TOTAL AMOUNT OF MONEY AND NATURE OF OTHER SUPPORT (HOUSING, TUITION, ETC.) FOR EVERY GRANT/SCHOLARSHIP LISTED.
*
IN THE SPACE BELOW, PLEASE LIST IN DETAIL ANY GRANTS AND/OR SCHOLARSHIPS OR LOANS YOU HAVE RECEIVED DURING YOUR UNIVERSITY EDUCATION. PLEASE DISCLOSE THE TOTAL AMOUNT OF MONEY AND NATURE OF OTHER SUPPORT (HOUSING, TUITION, ETC.) FOR EVERY GRANT/SCHOLARSHIP LISTED.
*
Are you a previous Dr. Harry Demirgian Memorial Scholarship recipient?
*
Yes
No
I hereby attest that the information above in this application is true and correct to the best of my knowledge.
Signature
*
Date
*
-
Month
-
Day
Year
Date
Supporting Documents Required
PLEASE UPLOAD A CERTIFIED COPY OF YOUR UNIVERSITY/COLLEGE TRANSCRIPTS (IF APPLICABLE)
*
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PLEASE UPLOAD APPLICANT'S OR PARENT'S FIRST 2 PAGES OF TAX RETURNS
*
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PLEASE UPLOAD YOUR 1000 WORD PERSONAL STATEMENT (INSTRUCTIONS FOR ESSAY INCLUDED IN ELIGIBILITY CRITERIA SECTION OF OUR COLLEGE SCHOLARSHIP WEBSITE PAGE
*
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PLEASE INDICATE BELOW HOW YOU HEARD ABOUT DR. HARRY DEMIRGIAN MEMORIAL SCHOLARSHIP *
*
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of
We are committed to maintaining the confidentiality of all scholarship application information provided to us. Your personal and academic details will be treated with the utmost privacy and will only be accessed by authorized personnel involved in the scholarship selection process. assure you that your information will not be disclosed to any third party without your explicit consent, except where required by law. By submitting your scholarship application, you consent to the collection, processing, and storage of your information for the purpose of scholarship evaluation and administrion.
Yes, I agree with the privacy policy and terms and conditions.
Please verify that you are human
*
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