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Home
About the Foundation
Board of Directors
Scholarships
Upcoming Events
Latest News
Photo Gallery
Testimonials
Contact Us
Donate
JCH Forms
JCH Forms
Scholarship Application
General Information
General Information
Name
First Name
Middle Initial
Last Name
Address
Street
Apartment / Unit#
City
State
Zip Code
Contact Information
Phone Number
Email Address
Household Income
Please choose one
$0 - $25,000
$25,001 - $50,000
$50,001 - $75,000
$75,001 - $100,000
$100,001- $150,000
$150,001 - $200,000
Above $200,000
Number in Household
Number of people in your household
High School Information
High School Information
Name
High School Name
GPA (4.0 Scale)
GPA
SAT (CR+Math)
SAT Score
ACT (composite)
ACT Score
Future College
Future College
College Name
College Name
College Address
Street Address
City
State
Zip Code
Anticipated Enrollment Date
Anticipated start date
Major
Intended major
High School Organizations
High School Organizations
Organization One
Name of Organization
Dates Served
Offices Held (If any)
Organization Two
Name of Organization
Dates Served
Offices Held (if any)
Organization Three
Name of Organization
Dates Served
Offices Held (if any)
Additional Organizations
Please list any other organizations here:
Community Organizations
Community Organizations
Community Organization One
Organization Name
Dates Served
Offices Held (if any)
Company Organization Two
Organization Name
Dates Served
Offices held (if any)
Organization Three
Organization Name
Dates Served
Offices Held (if any)
Additional Community Organizations
none
Please list any other community organizations here:
Honors and Awards
Honors and Awards
Briefly list any honors or awards
Please describe any awards received
Essays
Essays
Please submit two short essays that are a maximum of 300 words each.
Essay Question One
Personal History and Goals: Describe your educational and career goals and why these are your goals.
Essay Question 2
Life Challenges: Describe one of the most difficult life challenges you have faced and how you dealt with it.
Finalize
Finalize and Submit
Submitted by:
Email Address:
