HS Scholarship Application Form

ACOG HIGH SCHOOL SCHOLARSHIP APPLICATION FORM
PERSONAL INFORMATION
Full Name *

First Name Middle Name Last Name
Birth Date *

Month Day Year
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Phone Number *

Area Code Phone Number
E-mail *
Father's Name *
Father's Phone Number

Area Code Phone Number
Father's Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Father's Occupation & Employer *
Mother's Name *
Mother's Phone Number

Area Code Phone Number
Mother's Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Mother's Occupation & Employer *
Who in your family is affiliated with the Arlington Church of God? *
How many members of your family are attending college? *
What work experience have you had? *
School Information
High School *
G.P.A. *
Class Rank (as of 7th semester) *
Class Size *
ACT Composite *
Reading *
Writing *
Math *
English *
Science *
SAT Composite *
Critical Reading *
Math *
Writing *
Probable Major *
Probable Career *
Name of Colleges / Universities you've applied? *
Name of College/Univerity you plan to attend *
Admission Type *
Extra Curricular activities during High School only (include offices held - ex. student council president)

Include number of years participated
School
Community
Church
Honors / Awards
Scholarships granted / received (include amount)
On a separate sheet or in the text box below, please type the answer to the following questions in 250 words or less:

What are your aspirations for the future?

~Make sure your name and school are in the header.

~Please use spellcheck for grammar and spelling.

~Please double space your response.

~You can upload the document below or type your essay in the text box below.
Type Essay
Additional Required Materials:
Upload Essay
REQUIRED ENCLOSURES:
- Official High School Transcript (as of 8 ^th Semester - final transcript)
- College Acceptance Letter
- Essay
- Two (2) Letters of Recommendation from school/community persons
Submit the completed application with the required enclosures

on or before July 8, 2022

by 11:59 PM (if online)

or

3:00 PM (if delivered to church office in a sealed envelope)*

Arlington Church of God

539 South Arlington Street

Akron Ohio, 44306

If there is a concern regarding submission of any of the required documents, please immediately contact: Sis. Courtney Jones-Hunter cjoneshunter4@gmail.com or call 330-289-6620.
I certify that all of the information submitted is accurate and acknowledge that entering false or misleading information will result in the disqualification of my ACOG Scholarship Application.
Click to agree to terms above *

I Agree
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ACOG HIGH SCHOOL SCHOLARSHIP APPLICATION FORM

PERSONAL INFORMATION

School Information

Extra Curricular activities during High School only (include offices held - ex. student council president)

Additional Required Materials: