1. Senior Name (required)

2. Address (required)

3. Do you have a cell phone?
Yes-enter cell phone belowNo

4. If you have a cell phone number, enter it below

5. Email Address (required)

6. What High School are you attending (required)?

7. High School Address (required)

8. If you have a church home, list the church name and address below

9. Upload School ID. Take a picture of your School ID and upload it here (File must be 10 MB or less)

PARENT/LEGAL GUARDIAN INFORMATION.

10. Parent or Legal Guardian Name (required)

11. Parent or Legal Guardian Phone Number (required)

12. Parent or Legal Guardian Email (required)

NOTE: To qualify for the scholarship, you MUST demonstrate a FINANCIAL NEED and have Financial Literacy GPA of 3.0.

Please leave this field empty.

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