KYACAC 2019 Kimberly D Merritt "Achieve Your Dreams" Scholarship Application
Deadline: March 1, 2019
One $500 Award will be given for each of four regions of Kentucky (Northern, Central, Eastern, Western).

NOTE: Preference will be given to students from KYACAC member high schools.

***Students must sign into their Google Accounts in order to complete the form.

First Name *
Your answer
Last name *
Your answer
Home Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
County *
Your answer
Phone Number *
Your answer
Email
Your answer
High School Name *
Your answer
High School Location (Street, City, State, Zip)
Your answer
High School Counselor Name *
Your answer
Parent/Guardian Name *
Your answer
Parent/Guardian Address (Street, City, State, Zip) *
Your answer
Cumulative GPA (unweighted, 4.0 scale) *
Your answer
Intended College *
Your answer
Have any of your parents or grandparents earned a four-year degree? *
ACT Scores – English *
Your answer
ACT Scores – Math *
Your answer
ACT Scores – Reading *
Your answer
ACT Scores – Science *
Your answer
ACT - Composite *
Your answer
SAT Scores – Verbal
Your answer
SAT Scores – Mathematics
Your answer
SAT Scores – Combined
Your answer
Name someone who impacted or inspired your college admissions process, and state why they were beneficial in your journey into higher education. Please submit your response in 500 words or less. *
Your answer
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