2019 Scholarship Application

Applicants will be evaluated on each component of their submission.

Name Name * First Middle Last
Date of Birth Date of Birth * / MM / DD YYYY
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Phone * - ### - ### ####
Email *
High School Name *
School Counselor or Trusted Teacher *
School Address School Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Contact Person Contact Person First Last
A contact person is someone who is in regular communication with the applicant and is able to reach him or her; for example: an employee at the most recent school attended, such as a counselor, teacher, social worker, coach, or an employee of a community agency, such as a counselor, case manager, or shelter director.
Title
Phone Phone - ### - ### ####
Email
SAT/ACT Score (most recent)
Anticipated Field(s) of Study
Anticipated Colleges/ Universities (so state if you have been accepted) *
Anticipated Financial Aid (loans, scholarships, grants, money from family, etc.) *
Anticipated Support (family, friends, counselor, mentor, pastor, etc.) *
How did you hear about this scholarship? *
If awarded, are you interested in attending an award ceremony?

If awarded, are you interested in attending an award ceremony? Yes No
If awarded, would you be interested in participating in a forum to tell educators and policy professional what worked well with your education and what could be improved? *

If awarded, would you be interested in participating in a forum to tell educators and policy professional what worked well with your education and what could be improved? Yes No
If awarded, you would be interested in joining the NAEHCY alumni network and potentially mentoring other future scholars? *

If awarded, you would be interested in joining the NAEHCY alumni network and potentially mentoring other future scholars? Yes No
Your Personal Essay

Attach Files

Please upload a personal essay (500-800 words, double-spaced) that addresses the following questions:

a. How did homelessness impact your educational aspirations? How did you maintain your commitment to education while homeless?

b. How many times have you been homeless and for how long?

c. What are your future educational goals and how will this scholarship help you to accomplish those goals? Specifically, how would you use this scholarship, if awarded?

d. What are your long-term professional goals and career interests?
Your Official School Transcript

Attach Files
Letter Confirming Current or Former Homeless Status

Attach Files
Letter of Reference

Attach Files
Draw your signature into the box below.

Clear