Request edit access
"To foster, promote and reward academic excellence and achievement; To develop respect for--and observance of--the moral, social, and legal underpinnings of society and its institutions." - Earl Wyman

Applications will be accepted September 6, 2021 through November 1, 2021. A scholarship in the amount of $500 will be awarded to two (2) deserving applicants between 15 and 18 years of age. Winners will be contacted via email prior to and presented with the award in December 2021.

*Once the application has been submitted, a letter of support must be mailed or emailed in. Only one (1) letter of support may be sent to the following:
Mississippi Gulf Coast YMCA
Attn: Natalie Riddell
1810 Government St.
Ocean Springs, MS 39564
Sign in to Google to save your progress. Learn more
Email *
Applicant Full Name: *
Applicant Birthday: *
Applicant Email: *
Phone Number: *
School Attending: *
How are you associated with the Mississippi Gulf Coast YMCA or any organization/program that serves the community? *
Academic Achievement GPA: Shall be defined as the applicant's grade point average.
Give a short description of your current class schedule. Mandatory enrollment shall be required in a course of English, Mathematics, Science, and at least one elective. *
Behavioral Achievement: Defined as the participant's history concerning his/her support and observance of society's institutions and prevailing rules, laws, and regulations established to sustain it; Avoidance of confrontations with the law or authority. *
Non-Academic Achievement: Defined as extra-curricular school-related activities that are supplementary to academic achievement. *
Community/Service Achievements: Defined as non-school related activities, programs and projects undertaken voluntarily, participation in which they received no compensation. *
What are you short-term life goals? *
Tell us, in your own words, why you should win the Earl Wyman Performance Achievement Award: (Please note: A letter of support must accompany the application. Only one (1) letter of support may be sent via email or mail.) *
A copy of your responses will be emailed to the address you provided.
Clear form
Never submit passwords through Google Forms.
This form was created inside of Mississippi Gulf Coast Young Men's Christian Association, Inc.. Report Abuse