High School Scholarship Application Form

High School Scholarship Application Form
Name
First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Date of birth
MonthDayYear
Date
Gender
Other
Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
High School Name
High School Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Current Grade Level
Expected Graduation Date
MonthDayYear
Date
Cumulative GPA
Name of Scholarship
Scholarship Amount
Why are you applying for this scholarship?
Essay (250-500 words)
List your extracurricular activities, including sports, clubs, and organizations:
Rows Name Position/Role Duration
Activity 1
Activity 2
Activity 3
List your community service activities and volunteer work
Rows Organization Position/Role Duration
Activity 1
Activity 2
List any awards or honors you have received
Rows Name Description Date
Award 1
Award 2
Parent/Guardian Name
First NameLast Name
Parent/Guardian Occupation
Household Income
Academic Reference
Rows Name Position Contact Information
Reference
Personal Reference
Rows Name Position Contact Information
Reference
Applicant's Declaration

I hereby declare that the information provided in this application is true and accurate to the best of my knowledge. I understand that any false information may result in the disqualification of my application.
Applicant's Signature
Clear
Date signed
MonthDayYear
Date
Should be Empty:

Rows	Name	Position	Contact Information
Reference

Rows	Name	Position	Contact Information
Reference

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