Stipend Application Form 2026
Instructions: This form is part of the Instruction packet and should be completed by graduate students already enrolled college program or a technical/vocational program and 26 years old or younger. Please submit your application packet by August 26, 2026, HMAME Letter of Recommendation and 90 second pitch to the Education Achievement Committee at melvinwashington5@gmail.com
APPLICANT INFORMATION
Name
First Name
Middle Initial
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Daytime Telephone
Format: (000) 000-0000.
Evening Telephone
Format: (000) 000-0000.
Sex (M/F)
Date of Birth (Mo/Day/Year)
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
PARENT/GUARDIAN INFORMATION (Not applicable if self-supporting.)
Father's Name
First Name
Middle Initial
Last Name
Mother's Name
First Name
Middle Initial
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
EDUCATION INFORMATION
Name of Institution for 2026-2027
State
College Classification
Major/Area of Study
Cumulative Grade Point Average (if part time)
Full time/Part Time
Credit Hours
Back
Next
Education Achievement Committee
ACTIVITY INFORMATION
Church Activities
Community Service
School Activities
I understand that an incomplete application submission will be automatically disqualified and will not be considered by the Education Achievement Committee.
SIGNATURE
DATE
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
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