CATEGORY 2- CHILDREN OF AGENCY STAFF MEMBERS APPLICATION FORM-SWNAHRO

CATEGORY 2- CHILDREN OF AGENCY STAFF MEMBERS APPLICATION FORM

Applicant's First Name

Applicant's Last Name

Address

Date of Birth

Graduation Date

Phone Number

Which housing and or community development agency are you affiliated with?

Housing and Community Development agency Contact Name

Phone Number

Choose an option

High School Graduate/GED Recipient

High School Senior

Schools Attended / Dates Attended/ Final GPA/ Credits Completed / Degrees Received

What college, university, vocational, or post-secondary school do you plan to attend/ are attending? (include city & state):

Academic Major(s) will pursue, or are pursuing

Average length of program (2 years/4 years, etc.):

Summary of activities (i.e., resume) outlining past and current employment, internships, honors, awards, sports, clubs, and/or other recent school or community engagement.

List all scholarships awarded to you and the amount of each: (College students - also include everything awarded during high school)

List hobbies and any special interests:

Two (2) letters of recommendation from community leaders – Adults should know you well and can attest to your character, work habits, etc.) (ex. Teachers, coaches, church leaders, employers, etc.) No recommendations from family members will be considered.

Letters of Recommendation

List two personal references (name, addresses, and phone number):

Contact Information for Recommendation

Attach one 500 words or less typed essay, written by the applicant answering the following prompt: Tell us about yourself, your educational goals, and how this scholarship will help you achieve these goals.

Upload Essay

By checking this box I agree to the following

• That the information I have given is true to the best of my knowledge.

• To maintain satisfactory educational progress.

• To keep NAHRO informed of any changes in schools or enrollment status.

• To provide, or respond to NAHRO requests for, periodic updates on academic progress for the duration of the candidate’s receipt of scholarship funds.

• To consent to the use of my profile, progress, and testimonial, by NAHRO and its subsidiaries, for marketing and fundraising purposes.

• To authorize the office of financial aid to release my grades and pertinent information to NAHRO.

• To authorize the release of my contact information to contractor for the college program (if funded).

Agency certification completed and signed by ED/Administrator

An official (stamped or signed) high school transcript or GED which includes all high school grades through the first semester of the senior year.

A copy of ACT or SAT test scores

Name of Parent or Guardian:

Position held with the Agency and How Long

Number of children in family living at home:

Single Parent Household

Yes

Describe any special circumstances of financial or other need:

A photograph to be used in a slideshow presentation if selected. Applicants are allowing Southwest NAHRO use of their photographs unless they state otherwise in writing.