STICHIZ- PROJECT TEACH

PROJECT TEACH

Scholarship Application
Applicant Name*

First NameLast Name
Email*
example@example.com
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth: *

MonthDayYear
Date
Were you born in Haiti?*

YESNO
If No, briefly explain how you are of Haitian descent:
Name of your High School: *
Weighted Grade Point Average:*
Highest ACT or SAT Score: *
Which college do you plan on attending?:*
Work History: *
Awards and Recognition (if applicable/not mandatory)
Please list what college (s) you have been accepted to:*
Please state college you will be attending?:*
What is your intended major(N/A-if undecided):*
Upload file below or answer below:

Question 1: For years the Haitian diaspora has been plagued with negative stereotypes, forcing many including the youth to feel embarrassed about where they came from. How have or will you empower and give back to your community to help change some of the negative stereotypes that exist?

OR

Question 2: Being Haitian in America today, when you hear the term “Tu Es Belle” what does that mean to you?

(Please attach a separate page if necessary, or if you are providing a “clean” musical piece, please provide the link or MP3).
"I am answering question #____" (write this sentence with your chosen question number and proceed with your answer:*
Upload File

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I hereby waive my rights of privacy regarding disclosure to Project T.E.A.C.H. Inc. of the above information and I authorize and give consent to verify the contents of this application.
Name of Applicant;*

First NameLast Name
Date*

MonthDayYear
Date
Signature of Applicant*

Clear
How did you hear about this scholarship?:
PARENTAL CONSENT
(If under 18 years old) Name of Parent:
Signature of Parent if under 18

Clear
Should be Empty: