First Name *

Last Name *

Address Line 1 *

Address Line 2 *

City *

Zip Code *

Phone Number *

Phone number we can text *

Email Address *

Please share a link to one of your professional social media profiles. *

Parent or Guardian email address *

High School *

Cumulative High School GPA *

What is your anticipated major? *

Intended College, University or Vocational Tech Program *

What other scholarships or financial aid have you been awarded or applied for? *

What is the profession you wish to pursue and why? *

When you are finished with college, how likely are you to eventually live and work in the Elgin area *

Enter required value Likely Not Likely Not sure at this time

List your activities and involvement in the community and/or workplace. i.e., clubs, service, sports *

If awarded, what will the funds be used for? *

Upload One-Page Essay *

20MB max

Upload Letter of Recommendation *

20MB max

Upload High School Transcript *

20MB max

Upload Head and Shoulder photo of applicant *

20MB max

Agreement *

I AFFIRM THAT ALL STATEMENTS INCLUDED IN THIS SCHOLARSHIP SUBMISSION ARE TRUE, COMPLETE AND CORRECT.