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Scholarship Application
Last Name
(Required)
First Name
(Required)
Middle Name
Address
(Required)
Cell Phone Number
(Required)
Email Address
(Required)
Birthdate
(Required)
Name of Parents or Guardians/Cell Phone Number:
(Required)
Are you Employed?
(Required)
Place of Employment:
High School Attended:
School Address and Phone Number:
Date Entered School
MM slash DD slash YYYY
Membership in School Clubs and Organizations:
Date of Graduation or Expected Graduation
MM slash DD slash YYYY
Positions Held:
Honors/Awards:
Other Activities/Hobbies:
List two volunteer activities you have participated in while in high school. See attached Volunteer Hours Verification Form
List all colleges to which you have applied or will apply (Name of college, city and state):
Are you planning to attend a HBCU?
Yes
No
(*If yes, you will be considered for the Porter, Davis, Dunn, or Williams Scholarship)
(*If no, you will be considered for the Brown Scholarship)
(*If no, you will be considered for the Brown Scholarship)
Are you planning to pursue a career in Prince William County as a teacher? (*If yes, you will be considered for the Educational Advancement Foundation (EAF) Scholarship)
Yes
No
Write an essay of at least 100 words, but no more than 300 words, that explains your participation in volunteer activities in the community and what you have gained from volunteering.
Date
MM slash DD slash YYYY
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