Homer "Pete" Washington Community Fellowship
2014-2015 Fellowship Application
Deadline: Friday, May 2
First Name *
Last Name *
Middle Initial
Birthdate *
MM
/
DD
/
YYYY
Primary Phone *
Please signify (H) for Homer or (M) for Mobile
Secondary Phone
Please signify (H) for Home or (M) for Mobile
Email Address *
High School *
Will you be a graduating senior in the 2014-2015 academic year? *
Are you able to commit to this program for a full year? *
June 2014 to May 2015
Are you planning to pursue a post-secondary education program? *
Estimated Household Income *
The funding for Fellow compensation is determined by household income. This information will be used for that purpose.
Cumulative GPA *
List any extracurricular activities you have participated in: *
List any awards, recognitions, or certificates you have received: *
Briefly describe your education and career goals. *
ESSAY: How do you define "community" and how are you a part of it? *
500 words max
Submit
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