CATALYST
2023 Scholarship Application. General Instructions to Applicant 1. Complete an application at www.catalystpa.org or return via email to CATALYSTCaresForYou@gmail.com. The deadline is January 31, 2023. 2. Scholarships winners will be announced on February 25, 2023. Notices will be sent to winners via email. Funds will be sent directly to the college or university to be applied toward tuition or fees for one academic semester or academic year. Scholarships may be awarded based on availability.
1.) Personal Information: Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
DATE OF BIRTH
DOB
SS#
Email
Confirmation Email
example@example.com
Name of College/University you plan to attend
Name of College/University you plan to attend
Financial Aid Address and Phone Number of College or University
Which Scholarship are you applying for?
A.) Dr. Harold A. Harvey Scholarship Award ($500) B.) Esther M. Keys Davis Spirit Award Scholarship ($500) C.) Collette V. Dickason Cosmetology Scholarship ($200)
2. Education:
a. Name all secondary and/or technical schools you have attended in the last five years?
b. How many years do you plan to attend college, and what course of study would you like to pursue?
c. What future business or educational career will you likely pursue after finishing college?
d. What colleges have you applied to for admission? Please indicate acceptance status.
e. List scholarships, grants, or loans for which you have applied, and check the ones you plan to use. Indicate the funding amount you will receive.
3. a. List Academic, athletic, service, and extra activities.
3. c. List participation in community service and extra-curricular activities.
3 b. List participation in athletic activities.
4. Employment History. (last two years)
Employment 1
Empolyment 2
5. a. Your Expected Cost of College: Please provide the following information for each school which you have applied.
College
Tuition & Fees
Scholarships/Awards
Total Annual Cost
5. b. Your Expected Cost of College: Please provide the following information for each school which you have applied.
College
Tuition and Fees
Scholarships/Awards
Total Annual Costs
6. Financial Need Summary
Name of person(s) or parent(s) responsible for Tuition
6. b. Have you completed a FAFSA (Free Application for Federal Student Aid)?
7. Reference Letters: Please provide 1 letter of reference from the School, Church, or Community (excluding family).
8. a. Current GPA: This section is to be completed by your principal, guidance counselor, or admissions office.
8. Transcript History; This section is to be completed by your principal, guidance counselor, or admissions office.
8. a. Current GPA:
First This section is to be completed by your principal, guidance counselor, or admissions office.
8. b. SAT Score:
8. c. ACT Score:
This section is to be completed by your principal, guidance counselor, or admissions office.
Signature and Title:
I do state the above information is accurate to the best of my knowledge. Signature of Applicant
First and Last Name
Date:
Signature
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Central Pennsylvania Coalition United to Fight Cancer, CATALYST 2023 Scholarship Application
NOTE: This scholarship application form must be submitted with the required information to be considered. If you are applying for multiple scholarships, a new application does not need to be completed. Only one scholarship will be awarded per recipient per academic year. Applicants and family members of CATALYST members may apply. Applicants will be notified by email.
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