RENEWAL Application Form - Scholarship Grant

RENEWAL Scholarship Application Form

Application Deadline - March 1, 2017
Read and follow the instructions carefully prior to submitting your application.Be a graduating senior with a grade point average minimum of 2.0, or enrolled college student. All winners will be notified on or before the 1st of March 2017.
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 *

Prefix First Name Middle Name Last Name Suffix
Birthdate: *

Month Day Year
Mobile No. : *

Area Code Phone Number
E-mail : *
Where the confirmation will be send to

Home Address : *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Optional Informations :

Information regarding gender, ethnic origin and race are optional. The information is requested for post-scholarship report generation only and in no way affects your selection for college scholarship awards. However, providing this information may increase your opportunities for scholarships where donors have asked that priority consideration be given to students meeting certain demographic criteria (such as minority status, parent's place of employment, area of study, etc.)
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Gender:

Male Female
Are you a US citizen?

Yes No
Ethnic Origin:

Hispanic Non-Hispanic Not Indicated
Race? (Choose one or more):

White Black or African American Asian American Indian or Alaskan Native Hawaiian or Other Pacific Islander Non-Resident Alien
Please check veteran status (Check all that apply)

Veteran Child of a Veteran Grandchild of a Veteran Spouse of a Veteran None of the Above
Status at the time of application:

I will graduate in May 2017 I will be an incoming freshman graduating high school prior to 2017 I have attended college but have less than 32 college credit hours I have attended college but have at least 32 or more college credit hours I am a GED graduate with no college credit hours
Are you a first generation college student ?

Yes, I am the first among my parents or grandparents to attend college. No, either my parents or grandparents have attended college.
Major Area of Study:
Please indicate what is your major are of study
What is your Career Objective:

0/300
Have you submitted an application for admission?

Yes No
II. High School Information:
Are you or will you be a June 2017 high school graduate?

Yes No
High School Attended
Year of High School Graduation or GED:
Most recent cumulative GPA:
High School activities, community activities, volunteer work, honors, offices held:
III. ACT Information:
Year you took the ACT:
ACT composite (overall) score?
ACT scores are not required for scholarship eligibility. However, providing an ACT score can increase the likelihood of your selection as compared to other candidates.
All scholarship applicants reporting an ACT score will be asked to provide official verification.
Note: If you are a 2017 high school graduate and received a composite score of 26 or higher you are eligible for an automatic one-year full tuition scholarship.
V. For Students Currently Enrolled :
Approximate credit hours completed by May 2017:
Current GPA:
School activities, honors, offices held, etc.:
VI. Extras:
(School Name) administers many scholarships designed to offer aid to students 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.
Have you ever received a scholarship at (School Name)?

Yes No
Do you plan to complete your two-year degree with (School Name)?

Yes No
Do you plan to transfer to another college and complete a 4-year degree?

Yes No
Are you an Eagle Scout?

Yes No
Do you have a disability?

Yes No
Are you a GED recipient?

Yes No
Will you be working while attending (School Name)? *

Yes No
If so, will you work:

Full-time Part-time
VII. Essay
Your essay should be 300-500 words. You should address in your essay: How this scholarship can enhance your scholastic and educational goals.
Essay:

0/500
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:

RENEWAL Scholarship Application Form

I. Personal Data:

II. High School Information:

III. ACT Information:

V. For Students Currently Enrolled :

VI. Extras:

VII. Essay

VIII. Applicant's E-Signature