SCHOLARSHIP APPLICATION
Name of Applicant: ________________________________________
Phone: __________________________________________________
Home Address: ___________________________________________
City: ___________________________________________________
State: _________________________ Zip:______________________
I. SCHOLARSHIP INFORMATION
A. Name of High School: _________________________________________
B. Current Year in School: ________________________________________
C. Grade Point Average (cumulative): ________________________________
A verified high school transcript must be provided by your high school.
II. FINANCIAL NEED
A. Total family income as reported on federal income tax form: _____________
(A copy of current or previous year Form 1040 is required.)
B. No. of family dependents: ___
No. of children currently attending post-secondary schools: __
C. How do you intend to pay for your post-secondary education?
D. Please describe your economic need:
III. ADDITIONAL INFORMATION
A. Extracurricular Activities: (that support your creative, artistic and/or design interest)
A letter of verification on school letterhead must be obtained from your instructor or guidance counselor who is aware of your activities.
B. Employment History:
Employers (Please list all.) Date of Employment and Hours/Week
C. Essay
Please submit an essay (two-page maximum) on what you hope to accomplish as a result of this renewable scholarship.
D. Character References
Please submit two (2) letters of reference from teachers, counselors, or employees on their letterhead.
Return application to:
Village Scholars Program
4349 Fremont Avenue South
Minneapolis, MN 55409