Scholarship Application
Name *
Address (Must be within 28th Legislative District) *
Date of Birth *
MM
/
DD
/
YYYY
Preferred Telephone Number *
Preferred Email *
Student Status *
Current School
Class Rank (if available)
Anticipated Graduation Date
MM
/
DD
/
YYYY
Not Currently Enrolled Applicants
Cumulative GPA (4.0 scale)
Name(s) of Colleges/Universities where you have applied
Of these schools, where have you been accepted?
Date of College Acceptance
MM
/
DD
/
YYYY
Where do you plan to attend?
What will your status be during the 2019-2020 academic year? (check one)
Additional Information
Expected Family Contribution (EFC) located on FAFSA Student Aid Report (SAR) *
Are any of your immediate family members also applying for Senator Ellis' scholarship this year?
Have you received a Senatorial Scholarship from Senator Arthur Ellis in the past?
Please list the other financial aid that you expect to receive
Have you submitted your FAFSA for the 2019-2020 academic year?
***Submission of your FAFSA is required for your scholarship application to be considered. Once you submit your FAFSA, include a complete copy of your Student Aid Report to verify its completion. Please refer to: http://www.fafsa.ed.gov or call 1-800-4-FED-AID for assistance.
Please upload Student Aid Report verifying submission of your FAFSA application *
Acceptable file formats are: txt, pdf, doc, docx, rtf, jpg. The SAR report is about 4 pages long. The confirmation page alone is not sufficient.
Answer each of the following in paragraph form (no more than 250 words each):
a. Why do you want to attend college?
b. What fields are you interested in and why?
c. What personal attribute will you - or do you already - bring to your college?
Upload Short Answers: *
Required
Additional Requirements
1. Unofficial Transcript
Unofficial Transcript *
Required
Optional
You may include a brief statement explaining your financial situation and any other special financial circumstances.
Brief resume of your relevant extracurricular and volunteer activities.
You may include 1 letter of recommendation
Check Each Box Upon Completion of the associated task *
Required
Click below to digitally sign this form *
I verify that the information provided here is accurate and I am a resident of the 28th Legislative District. I am aware that incomplete applications and applications received after the April 1, 2019 deadline will not be considered.
*
Required
Verification
Please enter any two digits . Example: 12
*
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service