Scholarship Application

First Name *

Last Name *

Email *

Address *

Address Line 1

City

State

Zip Code

Age *

Preferred Phone *

Parents’ Names *

High School *

Graduation Year *

Hometown Newspaper (name and address/e-mail) *

High School Activities (Indicate years involved) *

Community Activities (Indicate years involved) *

Colleges Applied to (include whether you have been accepted) *

Briefly describe future interests (academically/personally). *

Briefly describe why you chose to apply for this scholarship. *

Attach Essay (PDF only) *

Click or drag a file to this area to upload.

Checkboxes *

I hereby certify that the work submitted for the Eisenhower College Alumni Association Scholarship is my own.

Initials, if adult has reviewed

Eisenhower College Community