Educational Grant Application Form

Autistic Angel Educational Grant Application
This educational grant is available to a high school graduating senior in the Hampton Roads area who has a minimum 2.7 GPA, has been accepted to a 2 or 4 year college or university and who has been diagnosed with Autism Spectrum Disorder (ASD).

All applications MUST be submitted by July 10, 2024. Applicants will be notified by August 1, 2024.
PERSONAL DATA
Full Name*

First NameMiddle NameLast Name
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
E-mail*
example@example.com
Date of Birth*

MonthDayYear
Graduating High School Name*
Father's Name

First NameLast Name
Phone Number
E-mail
example@example.com
Mother's Name

First NameLast Name
Phone Number
E-mail
example@example.com
INSTITUTION INFORMATION
Name of College or University Attending*
Major*
Tell Us About Yourself
Essay question: Why should we consider you for this educational grant?*
Please list any extra curricular activities you have participated in while in high school.*
Please tell us about any challenges that you have had to face and overcome in high school due to being on the spectrum.*
Tell us your future career goals*
Attach a copy of your college or university acceptance letter.*

Cancelof
I agree that if I am chosen for this educational grant, myself and my family are willing to attend the 2024 Autism Crush Festival on August 10, 2024 at Millpoint Park in Hampton, VA for a presentation of the grant?*

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Autistic Angel Educational Grant Application

PERSONAL DATA

INSTITUTION INFORMATION

Tell Us About Yourself