Independence Promise Scholarship Application
Due April 1st (For Fall Coursework Funding) or Nov 1st (for Spring Coursework Funding)
First Name *
Your answer
Last Name *
Your answer
School District Student Attends *
Birth Date
MM
/
DD
/
YYYY
ACT/Accuplacer Math Score *
Your answer
ACT/Accuplacer Reading Score *
Your answer
ACT/Accuplacer English Score *
Your answer
ACT Science Score *
Your answer
Overall GPA
Your answer
Expected High School Graduation Year *
Your answer
Gender *
Ethnicity *
Home Street Address *
Your answer
City *
Your answer
State *
Your answer
Zipcode *
Your answer
Phone Number *
Your answer
Guardian Phone Number *
Your answer
E-mail Address *
Your answer
Guardian E-mail Address
Your answer
Grade at which continuous enrollment in this school district began? *
Your answer
Did either of your parents/step-parents graduate from a 2 or 4-year college? *
Please choose the career you are planning at this time to pursue for your future. *
Ultimately, where do you plan to prepare for your future? *
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