Civic Duty Scholarship

Personal Information

Name*

First Name

Last Name

Address*

Address Line 1

Address Line 2

City

State/Province

ZIP / Postal

Country

Email*

Phone*

Semester you intend to start*

Class*

Scholarship Information

Do you have hands-on experience serving your community (including, but not limited to; Hospitals, Nursing Homes, Charities, etc.)?*

Please submit a personal essay (no more than 600 words) describing how you have shown unparalleled commitment through service in your community and why you deserve to receive this scholarship.*

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Acknowledgment

I have read and acknowledge the scholarship terms above and understand that a scholarship is not guaranteed to be given to me and may be revoked if terms are not met.

Signature*

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