Pan-Icarian Foundation Scholarship Application
The Pan-Icarian Scholarship is an award which covers one academic year. Eligible students may receive the scholarship up to 2 times provided they: (A) remain enrolled full-time, (B) maintain a minimum of not less than exactly a 3.0 cumulative GPA,(2.8 for Undergraduate Needs-Based Applicants) (C) re-apply for subsequent annual scholarships, and (D) comply with all other scholarship rules and instructions.
(Non-compliance will result in automatic disqualification of the application)

***The Pan-Icarian Scholarship is NOT guaranteed to any applicant.***

Applicants: It is important to note that this form cannot be saved and resumed at a later date.

It is also important to note that applicants must send the following items in a packet mailed directly to the scholarship chair. The application must be completed before July 1 and the accompanying application packet must be mailed in a single envelope (with the exception of student's transcripts) postmarked no later than July 1.

Email address *
Please select the type of scholarship you are applying for: *
First Name *
Your answer
Middle Name/Initial
Your answer
Last Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Street Address 1 (Home address) *
Your answer
Street Address 2
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Country *
Your answer
Telephone Number (home or mobile) *
Your answer
Place of Birth *
Your answer
Hometown(s) in Icaria or Fourni (optional)
Your answer
Father's Name *
Your answer
Father's place of employment and title/position *
Your answer
Mother's Name (including maiden name) *
Your answer
Mother's place of employment and title/position *
Your answer
(For Needs Based Scholarship Only): Parent's Combined Annual Gross Income from all sources last year: $
Number of siblings under age 25 *
Your answer
Number of siblings (and parents) currently in college or university *
Your answer
Chapter Name: *
Required
Number of years you (your parent(s)) have been a member in good standing in the PIB *
Your answer
Have you ever applied for a Pan-Icarian scholarship before? *
If so, what year(s)?
Your answer
Have you ever received a Pan-Icarian scholarship before? *
If so, what year(s)?
Your answer
College/University you are attending or will attend: *
Your answer
Location of College/University: *
Your answer
High School attended: *
Your answer
Location of High School *
Your answer
Student status fall semester *
Current cumulative GPA (incoming freshmen provide high school GPA: *
Your answer
List all previous higher education schools attended, dates attended, major(s) and degrees received: *
Your answer
List all relevant honors and awards received: *
Your answer
List all extra-curricular activities and employment positions held in the last five years: *
Your answer
Provide a description of your participation and involvement, if any, with your local chapter or the Pan-Icarian Brotherhood Youth:
Your answer
(For Undergraduate Needs-Based Scholarship Applicants) List all other sources of financial aid (including parents/legal guardians) and scholarships received (or to be received), including the amounts, dates and duration of such funding:
Your answer
I do hereby certify and attest that I meet the eligibility requirements stated above. Furthermore, I do hereby certify and attest that all required supplemental materials (i.e., transcripts and letters) are authentic, accurate and true. I acknowledge that providing misleading or false information in this application automatically disqualifies my application and my prohibit me from applying for future Pan-Icarian scholarships. *
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