You Belong - Scholarship Fund Application

Scholarship Application
Current Date*

MonthDayYear
Application window has closed

Scholarship details can be found here

Read and follow the instructions carefully prior to submitting your application. (You Belong Scholarship Details). All winners will be notified on or before the 30th of August.
I have read and understand the scholarship details:*

YesNo, I need to review the details
If selected, you will be asked for documentation to support the data you provide. Likewise, all correspondence and award agreements will be generated from the personal information submitted below. So, please use proper spelling, capitalization and punctuation.
I. Personal Data:

Tell us about yourself
Full Name*

PrefixFirst NameMiddle NameLast NameSuffix
Social Security Number :*
(e.g. 123456789)
Birthdate:*

MonthDayYear
Contact No. :*

Area CodePhone Number
E-mail :*
Where the confirmation will be send to
Tell us about your relationship with You Belong:
Name of your You Belong Coach or Mentor:
Home Address :*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How did you find out the You Belong Scholarship Fund?*

Coaching/Mentoring RelationshipYB ParticipantSocial MediaCommunity Market PlaceOther
Number of Children*

012
Are you a US citizen?*

YesNo
Race? (Choose one or more):*

WhiteBlack or African AmericanAsianAmerican IndianOther
Education status at the time of application:*

I will graduate in June of this yearI will be an incoming freshman graduating high school prior to this yearI have attended college (< 32 credit hours acquired)I have attended college (>32 credit hours acquired )I am a GED graduate with no college credit hoursI am acquiring training for certification/licensingI am ready for licensing examOther
Major Area of Study:*
Please indicate what is your major are of study
What is your Career Objective:*

0/300
What are you working towards:*

2-yr degree4-yr degreeMastersPHDCertificationLicensing
Extra activities, community, volunteer work, honors, offices held:
Have you submitted an application for admission?*

YesNo
II. High / Technical / Trade School Information:
Are you or will you be a June 2018 high, technical, or trade school graduate?*

YesNo
Name of institution
Year of High School Graduation or GED:*
Most recent cumulative GPA:*
III. ACT Information:
Year you took the ACT:
ACT composite (overall) score?
All scholarship applicants reporting an ACT score will be asked to provide official verification.
V. For Students Currently Enrolled:
Approximate credit hours completed by Fall of this year:
Current GPA:
You Belong offers scholarships designed to offer aid to young women that represent unique characteristics. Please check each of the qualifiers below that apply to you. This data may increase your likelihood of qualifying for selected scholarships. Please note, if you are awarded a scholarship based on any of these qualifiers, you will be asked to produce documentation verifying your unique eligibility.
Do you have a disability?*

YesNo
Will you be working while attending school?*

YesNo
If so, will you work:

Full-timePart-time
Do you have a relationship with anyone affiliated with You Belong?*

YesNo
If yes, Name and
Role

Board MemberCommittee MemberCoachMentorVolunteerMenteeSupporter
VII. Essay
Your essay should be 300-500 words. You should address in your essay: your academic, techincal, or trade goals, what you intend to do with your education, and why a scholarship is important to you. Include any academic and non-academic accomplishments, personal characteristics, or experiences that make you uniquely worthy of scholarship consideration.
Essay:*

0/500
How are you engaged with the You Belong community?*
VIII. Applicant's E-Signature
By signing (typing your legal name) in the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.
E-Signature:*
Should be Empty:

Scholarship Application

Application window has closed

I. Personal Data:

II. High / Technical / Trade School Information:

III. ACT Information:

V. For Students Currently Enrolled:

VII. Essay

VIII. Applicant's E-Signature