Community Scholarships

Applicant Information

Name

First Last

Permanent Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Mailing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Phone

Mobile Phone

Email

Gender

Male
Female
Prefer Not to Answer

Date of Birth

Which categories describe you?

White
Hispanic, Latino, or Spanish origin
Black or African American
Asian
American Indian or Alaska Native
Midlle Eastern or North African
Native Hawaiian or Other Pacific Islander
Some other race, ethnicity, or origin
I prefer not to answer

School Information

High School Name

Class Rank

Class Size

High School Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Cumulative GPA

Date of Graduation

Name of Accredited 2- or 4-Year College, University, or Trade School You Will Attend During the Coming Semester/School Year

Address of Accredited 2- or 4-Year College, University, or Trade School You Will Attend During the Coming Semester/School Year

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Major

Annual Tuition

Financial Aid Information

Family Size

Number of Household Family Members in College in the Coming Semester/School Year

I Qualify for Free or Reduced Lunch at School

Yes
No

I Reside in a Single Parent Home with a Yearly Income of Less than $40,000

Yes
No

I Reside in a Two-Parent Home with a Yearly Income of Less Than $60,000

Yes
No

Additional Scholarships

Please indicate other scholarships already awarded covering the period of aid requested in this application. Include the following information for each scholarship:

Source

From:

To:

Annual Amount Awarded

Source

From:

To:

Annual Amount Awarded

Source

From:

To:

Annual Amount Awarded

How Did You Hear About This Scholarship?

Please indicate how you learned about The L.Y.F.E. Foundation Scholarship.

Activities

Please list your extracurricular activities.

Name of Organization

Level of Participation

(i.e., Office held, honors, volunteer)

Description of Activities

Name of Organization

Level of Participation

(i.e., Office held, honors, volunteer)

Description of Activities

Name of Organization

From:

To:

Level of Participation

(i.e., Office held, honors, volunteer)

Description of Activities

Activity Awards

Please list any awards/recognitions you’ve received. Include the following information for each award/recognition:

Award/Recognition

Organization

Date

Award/Recognition

Organization

Date

Work Experience

Please provide work experience for the past three (3) years. Include the following information for each entry:

Employer

Job Title

Duties

Start Date

End Date

Employer

Job Title

Duties

Start Date

End Date

Employer

Job Title

Duties

Start Date

End Date

Applicant's Statement

In submitting this application, I certify that:*

I have met ALL Eligibility requirements as outlined and acknowledge that misrepresentation of the information presented may be grounds to rescind the scholarship award. I also agree to inform the Scholarship Committee Review Board of any significant changes to that information.

*

I am willing to appear for a personal interview and forward any additional information, if deemed necessary.

*

I agree to accept the decision of the Scholarship Committee Review Board of The L.Y.F.E. Foundation, Inc.

*

I will use the proceeds of any scholarship received for the payment of tuition, required fees, room and board, and/or required materials only.

*

If I am awarded a scholarship, I will provide satisfactory evidence, as required by The L.Y.F.E. Foundation, Inc., of my full-time enrollment during the period for which the scholarship is awarded.

*

I understand that submission of this application constitutes permission to use my name and/or photograph for promotional purposes in all L.Y.F.E. Foundation publications.

Name

This field is for validation purposes and should be left unchanged.

View the list of scholarships available this year in your community!

SCHOLARSHIP 2020-2021

Applicant Information

School Information

Financial Aid Information

Additional Scholarships

How Did You Hear About This Scholarship?

Activities

Activity Awards

Work Experience

Applicant's Statement