The Jefferson R. Voss Education Fund
PLEASE READ – It is important that you read ALL eligibility requirements before proceeding to the online scholarship application.

Eligibility for Scholarships

• Preference will be given to those that self-identify as lesbian, gay, bisexual, transgender or queer.
• Current resident and planning to attend school in the Central Florida area (Brevard, Lake, Orange, Osceola, Polk or Seminole Counties). Proof of acceptance is required.
• Must participate and be engaged regularly in programming and activities at Zebra Coalition (i.e. workshops, social activities, support groups, youth council, receiving services, etc).
• Must be 24 years of age or younger at the time you are applying.
• Sign acknowledgement form agreeing to the outlined terms and conditions of the application.
• Must qualify for the program and educational institution they are applying for.
• Demonstrate financial need.
• Must submit a personal essay of no more than 500 words explaining how you will “give back” to the LGBT+ community.
• Complete online application in full by required deadlines.
• Must attend the annual awards ceremony.
• A picture and short biography of each scholarship award recipient will be used on Zebra Coalition's website, social media, print, etc.

General Information
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Legal First Name
Your answer
Middle Name
Your answer
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Legal Last Name
Your answer
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Preferred Name
Your answer
Email address *
You will be contacted at the email address you provide.
Your answer
Phone number *
You will be contacted at the phone number you provide.
Your answer
Permanent Address *
You will be contacted at the mailing list you provide.
Your answer
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City
Your answer
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State
Your answer
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Zip Code
Your answer
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County
Your answer
Personal Information
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Your date of birth
MM
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DD
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YYYY
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Your age today
Your answer
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Your sexual/romantic orientation
If you would like to provide additional information or clarification regarding your sexual orientation or outness, please do so here:
Your answer
Assigned Sex at Birth *
What sex were you assigned at birth, on your original birth certificate?
Your Current Gender Identity *
What is your current gender identity? (check all that apply)
What are your gender pronouns? *
(e., "she," "hir," "he," etc.)
Your answer
How would you describe your racial/ethnic background?
The race and ethnicity information you provide will not be used in a discriminatory manner. However, you may choose to not answer this question by checking the option: I prefer to not respond.
Family Information
Please tell us about your family circumstances.
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Are you currently or have you ever been in foster care?
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Are you currently or have you ever been homeless?
If you checked that you are currently in foster care or homless please describe the circumstances:
Your answer
Is there any information you would like to share regarding yoru family or your relationship with your family?
Your answer
Degree Information and Future Plans
Education previously completed *
(check all that apply)
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What academic concentration/major are you interested in?
Your answer
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If you could achieve any professional position within then next ten years, what woudl it be?
Your answer
School Information
Enter up to 3 school choices that you are applying to
Which semester do you plan to attend school? *
(check all that apply)
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What school year are you applying for?
Your answer
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1) Name of school
Your answer
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City school is located
Your answer
Type of school
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Will you be enrolling:
2) Name of school
Your answer
Type of school
Will you be enrolling
High School Information
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Did you or will you graduate from high school?
Name of high school you graduated from
Your answer
City high school is located
Your answer
State high school is located
Your answer
Date of graduation
MM
/
DD
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YYYY
Overall GPA
Your answer
If your GPA requires additional information, explain here:
Your answer
If you answered no to graduating high school, did you obtain a GED?
In the space provided, provide explaination for neither completing high school nor obtaining a GED:
Your answer
Is there any information you would like to share regarding your high school experience or your relationship with your peers?
Your answer
Essay
This is a critical component of your application. There are no grammar-or spell-checking tools on this page. Therefore, we suggest you draft your essay in a separate application such as MS Word or the body of an empty email message. Be sure to use the spell-check feature (if available) and limit your essay to no more than 500 words. Keep spaces, hard returns/enters, indents, and tabs to a minimum, so your essay will more cleanly print out with the rest of your application.
How have your life experiences prepared you to give back to the LGBT+ community? *
Your answer
Extracurricular and Volunteer Activities
Please list and highlight up to ten of your most significatn extracurricular and volunteer activities.
Your answer
Professional/Work Experience
List either professional or work experience that is current as well as any other professional or work experiences from the past. You can list up to three.
1) Company Name:
Your answer
Position Held:
Your answer
Describe job responsibilities
Your answer
Are you still employed here?
2) Company Name
Your answer
Position Held:
Your answer
Describe job responsibilities:
Your answer
Are you still employeed here?
3) Company Name
Your answer
Position Held:
Your answer
Describe job responsibilities:
Your answer
Are you still employed here?
Awards and Honors
List any awards/honors and the year(s) you recieved them. You may list a maximum of ten awards/honors.
Your answer
Student Affirmation
By clicking on the "submit" button below, I acknowledge that my entry and application becomes the property of the Zebra Foundation for Youth and the Zebra Coalition. If selected as the scholar for The Zebra Foundation for Youth and the Zebra Coalition may use my name, image and biographical information in promotional efforts related to the Jefferson R. Voss Education Fund. I give permission for Zebra Foundation for Youth and Zebra Coalition representatives to contact me at the mailing address, phone number and email I provided in this application. I certify that the information contained in this application is true.
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Applicant's Signature
Your answer
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Date
Your answer
Submit
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