6 Shining Diamonds Scholarship/Nomination Application
Complete the scholarship/nomination application. Preserve the original section order and labels as closely as possible.
Application Type
Application Type
*
Please Select
Student Self-Application
Student Nomination
Are you self-nominating yourself?
*
Please Select
Yes
No
Nominator Information
Nominator Full Name
*
Relationship to Student
*
Organization (if applicable)
Nominator Email
*
example@example.com
Nominator Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Why are you nominating this student?
*
Student Information
Student First Name
*
Student Last Name
*
Student Preferred Name
Student Date of Birth
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Student Email
*
example@example.com
Student Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
City
*
State
*
Current School
*
Current Grade Level
*
Please Select
12th Grade (Senior)
Currently an 11th grader (Junior) going to the 12th grade (Senior)
Expected Graduation Year
*
Post-Graduation Plans
Post-Graduation Plans
*
Attend a 4-year college or university
Attend a community college
Trade school or vocational program
Enter the workforce
Join the military
Start a business
Take a gap year
Other
Intended Major / Career Interest
Student Story
Tell us about yourself. (250–500 words). Include: Who you are; Your goals; What motivates you; Challenges you’ve overcome; What receiving this scholarship would mean to you?
*
Student Story Essay Upload
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of
Achievements & Involvement
Academic Honors
*
Leadership Roles
*
Clubs
*
Sports
*
Awards
*
Volunteer Activities
*
Work Experience
*
Resume Upload
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Choose a file
Cancel
of
Financial Consideration
Would financial support significantly impact your ability to pursue your goals?
*
Please Select
Yes
No
Somewhat
Unsure
Financial Impact - Explanation
Media Permission
Media Permission - I agree to photos
*
Yes
Media Permission - I agree to recognition materials
*
Yes
Media Permission - I agree to website/social media features
*
Yes
Certification & Signature
Certification - Information provided is accurate
*
I certify that the information provided is accurate and complete
Certification - I understand submission does not guarantee selection
*
I understand that submission does not guarantee selection
Signature
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
Submit
Should be Empty: