Scholarship Application Form 2026

Education Achievement Committee
Hemingway Memorial AME Church
Scholarship Application Form 2026
Instructions: This form is part of the Scholarship Application packet and should be completed by high school seniors or students about to receive a GED.
Please submit your application packet by August 26, 2026 and 90 second pitch to the Education Achievement Committee at melvinwashington5@gmail.com
APPLICANT INFORMATION
Name

First NameMiddle InitialLast Name
Address

Street Address

Street Address Line 2

CityState / 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)

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
PARENT/GUARDIAN INFORMATION
Father's Name

First NameMiddle InitialLast Name
Mother's Name

First NameMiddle InitialLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
EDUCATION INFORMATION
Intended College/University
City
State
Major/Area of Study
Name of High School
City
State
Classification
Cumulative Grade Point
Scholarship Application
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