Application for Annual Scholars Allowance Program

- Step 1 of 3

Student Information

Student Name *

First

Middle

Last

ID Number

Grade Level This Coming School Year

E-mail

Phone

Date of birth

Click the Year to change the year.

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Can you tell me something about yourself? *

Extra-Curricular, Organizations (include references and contact numbers)

Are you living with your parents?

Who is paying for your education?

Parents
Siblings
Guardian
Scholarship

Why do you need this cash assistance?

How do you plan to use the cash assistance?

Share about your dreams for the future

(max of 5 sentences)

What do you think is the top 3 biggest obstacles in attaining your dream?

(max of 5 sentences)

Why should we pick you?

What are your strengths?

What are your weaknesses?

Which is heavier a pound of gold or a pound of feathers? *

Gold
Feathers
Same

Why? *

Which is heavier an ounce of gold or an ounce of feathers? *

Gold
Feathers
Same

Why? *

What are your biggest achievements so far?

What motivates you? How do you motivate the others?

Are you a leader or a follower?

Leadership is action not position, the more you act like a leader, the more you'll become one.

What is your dream job?

Who inspires you? Why?

You only have 2 buckets, one for 5 liters and one for 7 liters, how would you measure 6 liters? *

Family Information

Is your father living or deceased? *

Living
Deceased
Don't know

Father's Name *

First

Middle

Last

Date of birth *

Highest Educational Attainment

Primary
High School
College

What School?

What Course?

Source of Income? *

Employed
Self-employed/Business
Unemployed

Employer

Phone

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Gross Monthly Salary *

Name of business

Phone

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Gross Monthly Salary *

Is your mother living or deceased? *

Living
Deceased
Don't know

Mother's Name *

First

Middle

Last

Date of birth *

Highest Educational Attainment

Primary
High School
College

What School?

What Course?

Source of Income? *

Employed
Self-employed/Business
Unemployed

Employer

Phone

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Gross Monthly Salary *

Name of business

Phone

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Gross Monthly Salary *

Any Siblings?

How many are dependent?

How many are independent?

Do you have any questions?

Signature *

Website

Give And You Shall Receive!

"For it is in giving that we receive." - Saint Francis of Assisi.

Donation Form *

I would like to donate by credit card

Choose amount - $300 will help 1 kid for 1 year *

$10
$20
$50
$100
$300
Specify Amount

Donation Amount *

Name *

First

Last

Phone *

Email *

Donation Total:

$ 0.00

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Message

Application for Annual Scholars Allowance Program

Student Information

Family Information

Give And You Shall Receive!

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