HSED Scholarship Application 2022
The City of Racine and Mayor Mason believe in your potential! We want to encourage and support adults in the City who are ready to go back to school to earn their high school credential.

We know that going back to school requires a lot of time, effort, and sacrifice. To support you in achieving your goal, the City of Racine is now offering scholarships of up to $1,500 to help City residents pay the bills while they enroll in and graduate from the YWCA SEW's FREE 5.09 High School Equivalency Diploma (HSED) program.

The YWCA's FREE 5.09 program is based on schoolwork (not tests!) and will allow you to earn your high school credential in 20 weeks or less. You will earn the $1,500 City Scholarship as you go through the 5.09 program, and the Scholarship payments are for you to use for whatever you need as you go through the program.

If you live in the City of Racine, are ready to enroll in the 5.09 HSED program, and want to be considered for a City scholarship to help you pay your bills while you're earning your high school credential, fill out this application to get started!
Sign in to Google to save your progress. Learn more
Email *
First Name *
Last Name *
Date of Birth *
MM
/
DD
/
YYYY
Street Address *
City *
ZIP Code *
Phone Number *
Please Confirm Your Email Address *
How did you learn about the City of Racine HSED Scholarship Opportunity? *
Race (This question is asked for demographic purposes only and does not impact your scholarship eligibility) *
Ethnicity  (This question is asked for demographic purposes only and does not impact your scholarship eligibility) *
Primary Language  (This question is asked for demographic purposes only and does not impact your scholarship eligibility) *
Gender  (This question is asked for demographic purposes only and does not impact your scholarship eligibility) *
Are you a City of Racine resident? (Before answering, please confirm by looking up your street address in https://myvote.wi.gov/en-us/ - if that site tells you that residents at that address vote at a City of Racine polling place, you are a City resident; if it tells you that you vote at a Mt Pleasant, Caledonia, Wind Point, etc. polling place, then you are not a City of Racine resident and are not eligible for these scholarships) *
Household Annual Income (This question is asked for demographic purposes only and does not impact your scholarship eligibility) *
Are you a parent of a child under 18 years old?  (This question is asked for demographic purposes only and does not impact your scholarship eligibility) *
Total number of adults & children in your household  (This question is asked for demographic purposes only and does not impact your scholarship eligibility) *
Last high school attended *
Last grade completed *
Tell us why going back to school to earn your high school degree is important to you. *
Tell us how receiving a City scholarship for the 5.09 HSED program will help you to participate in the program and achieve your goals.   *
Do you understand that if you receive a City scholarship, you will need to: 1) Sign a Scholarship Acknowledgement Form; 2) Complete and submit a W-9 form with a valid Social Security Number (SSN) or Individual Tax Identification Number (ITIN); 3) Provide proof of residency in the City of Racine; and 4) Remain a City resident while participating in the 5.09 HSED program? *
If you are awarded a City scholarship, would you be willing to work with the free, professional counselors at the Racine Financial Empowerment Center (FEC) to receive free, confidential financial counseling? *
Have you already enrolled in the YWCA SEW's 5.09 HSED Program? *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy