HAROLD ELLISON SCHOLARSHIP APPLICATION

Harold Ellison Scholarship Application

First Name

Last Name

Name of Parent(s) or Guardian(s)

Date of Birth (MM/DD/YYYY)

Gender

Female
Male
Other
Prefer not to say

Phone

Are you a U.S. Citizen?

Address

Address 2

City

State

Zip

County

High School attended

College or University you wish to attend

Intended Major

Short Answer non-attachment field option: Briefly discuss your goals and aspirations for your college years and the years immediately following college graduation.

Of your academic and personal accomplishments, describe the one that gave you the feeling of greatest achievement.

Upload your High School Transcripts (including SAT/ACT), Letter or Recommendation, Extra-Curricular Activities (i.e. Athletics, Social Clubs, St. Govt., Community Involvement, Honors, Awards, etc.) and Work Experience. Please include all years participating, offices held and recognition/honors. (.doc, .docx, .pdf)

Add another

Attach your essay discussing what you think is one of the most critical issues facing our society today. (.doc, .docx, .pdf)

Nomination letter from high school principal or counselor. (.pdf, .doc,.docx)

All attachments above must not exceed 50 MB combined.

Have you received any scholarships?

Have you applied for any scholarships, if so which ones?

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HAROLD ELLISON SCHOLARSHIP APPLICATION

Harold Ellison Scholarship Application