Scholarship Form for Non-Regional Group Affiliates

Scholarship Program Form for Non-Regional Group Affiliates
Submitter's Information
Submitter's Name*

First NameLast Name
Submitter's Email*
example@example.com
Student Applicant Information
Student Applicant Name*

First NameLast Name
Student Applicant Email*
example@example.com
Year Student Relocated*
Student relocated FROM*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
TO*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Student Applicant Requirements
Upload documentation confirming that student is good-standing*

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Upload confirmation of student's GPA is 2.5 or better on a 4.0 scale*

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Upload list of extra-curricular activities

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Please attach student’s essay/video by May 31st by 11:59PM PST. No applications will be accepted after May 31st.*

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School Information
Applicant's School Name*
School Location*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
School Registrar or Financial Aid Office Contact Person*

First NameLast Name
School Registrar or Financial Aid Office Email*
example@example.com
School Registrar or Financial Aid Office Phone Number*
Please enter a valid phone number.
Upload School's W-9 Form

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Should be Empty:

Scholarship Program Form for Non-Regional Group Affiliates