| Applicant
Name: |
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| Mailing
Address: |
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| City: |
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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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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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Does Diversity matter? If yes, why? If not, why not?
How do you deal with Diversity? Give concrete, anecdotal examples from your own life.
Can we stand strong when we are diverse? How? Provide an explanation.
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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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