Scholarship Application Form

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Financial Information
How do you plan to finance your schooling?*
Have you received any scholarships?*
- Yes
- No
If you have been awarded scholarships, please list all scholarships, the organization making the grant

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Goals and History
List groups to which you have belonged (Youth Groups, 4-H, etc.). Include, at a minimum, the years in during which you participated, your leadership roles in each group (if any), and a brief description of the specific activities in which you were involved.
What are your occupational goals?*
What are your life goals?*
Teams or activities in which you have participated (sports, debate, yearbook, etc.)

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Essay Questions
David was a leader in every aspect of life. He had the unique ability to unite individuals to achieve common goals. More importantly, David led by example. He always held himself to the highest standard and accountability. Please describe how you’ve demonstrated leadership.*
David faced adversity with courage, determination, and unwavering faith. Please describe an experience where you faced adversity and how you responded.*

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*Please note - Award letter, letter of acceptance, official transcript, and schedule for semester are all required fields
Award Letter (All Scholarships received – with dollars amounts) PDF format only*
Drop files here or

Accepted file types: pdf, Max. file size: 10 MB.
Letter of acceptance from the College/University you will be attending (PDF format only)*
Accepted file types: pdf, Max. file size: 10 MB.
Attachments
A certified or other official transcript of grades through at least the seventh semester of high school (PDF format only)*
Accepted file types: pdf, Max. file size: 10 MB.
Class schedule for the second semester of senior year to confirm credits (PDF format only)*
Accepted file types: pdf, Max. file size: 10 MB.
One or more letters of recommendation from your teachers, school faculty, or members of the community (PDF format only)
Drop files here or

Accepted file types: pdf, Max. file size: 15 MB.

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Certifications by Applicant
I certify and agree that:
1. The information I provided in this application is complete and accurate to the best of my knowledge.
2. I meet eligibility requirements of the Foundation scholarship program described in the enclosed Scholarship Selection Criteria & Administrative Procedures. I understand that my submission of an application and/or or meeting eligibility criteria does not guarantee that I will receive a scholarship grant.
3. Upon request, I will provide the Foundation proof of information to verify my eligibility, including a copy of my U.S. Income Tax Return and official transcripts of grades. My scholarship may be terminated if I falsify information or fail to use the award for purposes described in the enclosed Scholarship Selection Criteria & Administrative Procedures.
4. If I receive a scholarship grant, I: (A) authorize my educational institution to provide any information (including transcripts and information regarding enrollment) to the Foundation that it requests to verify my eligibility under the scholarship program, and (B) agree to refund any scholarship grant funds not used for purposes described in the enclosed Scholarship Selection Criteria & Administrative Procedures.
Applicant’s initials*
Today's date*
MM slash DD slash YYYY

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Student Contact Information