Creole and English Version of Haiti Scholarship Application
Please realize that this is only an application. It does not mean you are guaranteed to receive a scholarship.  We can only reward about half of those that apply. Thank you for taking the time to fill out our application.

Tanpri, reyalize ke sa a se sèlman yon aplikasyon. Li pa vle di nou garanti w resevwa yon bousdetid. Nou kapab sèlman rekonpanse sou mwatye nan moun ki aplike. Mèsi poutèt ou pran tan nan ranpli aplikasyon nou an.
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First Name *
Non
Your Information
Last Name *
Denye Non
Male/Female *
Address
Adrès Postal
Home Phone
telefòn Lakay
Mobile Phone
telefòn mobil
Email Address *
adrès imel
Date of Birth
dat nesans
School Information
enfòmasyon lekòl
Name of School Currently Attending or Wishing to Attend
Non lekòl la nan yé kounye a oswa ki vle Patisipe nan
Name of School Official to Contact
Non ofisyèl lekòl yo kontakte
Phone Number
nimewo telefòn
School Address
adrès lekòl
Email *
adrès imel
Current Grade Level
aktyèl nivo klas
Current course of study
aktyèl etid la
Career Goal
objektif karyè
Essay Questions
redaksyon kesyon
Why do you need this scholarship?
Poukisa ou bezwen bousdetid sa a?
What do you hope to do with your education?
Ki sa ou espere fè ak edikasyon ou a?
Given that HaitiScholarships are not for 100% of the cost, how do you plan on paying for the rest of your costs?
Bay sa HaitiScholarships yo pa pou 100% nan pri a, ki jan ou fè plan sou pou peye pou rès la nan frè ou la?
Write a brief personal statement explain how you plan to positively impact the future of Haiti, and how this scholarship will help you achieve that.
Ekri yon brèf deklarasyon pèsonèl eksplike kouman ou fè plan pozitivman impact avni Ayiti a, e ki jan bousdetid sa a pral ede w reyalize sa.
Would you be willing to help Haiti Scholarships in any of the following ways? Please check all that apply.
Èske ou ta kapab byen vle ede Ayiti Bousdetid nan nenpòt nan fason sa yo? Tanpri tcheke tout sa ki aplike.
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