Need Based Scholarships Page 1 Page 2 Page 3 Page 4 Name Title Choose One Mr. Ms. Mrs. Prof. Dr. First Name * Last Name * Email Address * Contact Number * Parents/Guardian Name * Phone Number Address Academic Information Name of School * Class/Grade * Expected Graduation Date * Grade Point Average * Major & Minor (College Students) Living with Parent or Guardian? * Yes No Parent or guardian employed? * Parent or guardian salary (per month) * No income Under $100 Above $150 Are you employed? * Yes No How much do you earn per month * No income Under $25 Under $50 Over $100 Do you have children? * Yes No How many children do you have? Grade sheet/transcript * Additional Information Briefly explain why you need this scholarship List any recognition, awards or honors that you’ve received in school, church, work, or community in the last several years. List two people in your community who can recommend you
