| Applicant
Name: |
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| Mailing
Address: |
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| City: |
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| State: |
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| Telephone
Number: |
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| E-Mail: |
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| Program: |
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| We
would encourage you to seek sponsorship/support from your local community
based groups who would benefit from your participating in our program. |
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| Have
you or your family done anything to raise money for LEARN to LIVE Together,
Honors Leadership Academy for Young Women in your community by contacting
religious, service, community groups? |
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Yes
No |
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| If
yes, please give details of results: |
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| Should
the review of your Scholarship Application be based on:
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| If
applying for Merit reasons, please write an essay (no longer than
one double spaced printed page) on the following topic ( use the space
provided): |
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How was the Current Economic Turbulence caused? Has it affected your life? In what way/s? What would
you do if you were the leader in charge of helping the nation through these difficulties? Can individuals make
a difference? How? In what ways?
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| If
applying for Need reasons, please provide us following information: |
| Occupation
of Mother or Guardian: |
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| Business
Address: |
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City:
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| State: |
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| Zip: |
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| Occupation
of Father or Guardian: |
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| Business
Address: |
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| City: |
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| State: |
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| Zip: |
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Total Annual Househould Income:( if income is less than $40,000, please mail
a copy of your parents' guardians' Federal 1040 Income Tax Form, pages
1 &2)
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| Name
and ages of children in your family supported by your parents/guardians:
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| Please
specify any special needs, hardships or extenuating circumstances you
would like to have considered by our team. |
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