Eligibility Form for GEAR UP 2020 Scholarship
This is an Eligibility Form to determine if you qualify for a GEAR UP needs-based scholarship.

All information provided will be kept strictly confidential, and will only be used for the sole purpose of determining your eligibility for the 2020 GEAR UP Scholarship. This opportunity is only offered to students who plan to further their education by pursuing a Bachelor’s degree at a 2-year or 4-year institution, or to students who attend a technical/trade school taking courses that will lead to a Bachelor’s degree. The maximum scholarship award will be up to $4,000 ($1,000 for 4 semesters).

Minimum requirements:
• complete this Eligibility Form and submit by the extended deadline of May 30, 2020
• plan to attend a college/university or technical/trade school (pursuing a Bachelor’s degree)
• complete the FAFSA process
• be able to demonstrate that you have a financial need
First Name *
Middle Initial
Last Name *
Home Address *
City *
State *
Zip Code *
Personal Email Address (one you check regularly) *
Social Security Number *
Date of Birth *
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/
DD
/
YYYY
Ethnicity *
Cell Phone # *
Current High School *
Have you completed the FAFSA process? *
Name of the College/University you plan to attend? *
City where the College/University is located? *
State where the College/University is located? *
Major area of study? *
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