Miriam Mavis Moore
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Scholarship Application Form
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Step
1
of 3
I. Personal Data
Tell us about yourself
Name
*
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II. Optional Information
Information regarding gender, ethnic origin and race are optional. The information is requested for post-scholarship report generation only and in no way affects your selection for college scholarship awards. However, providing this information may increase your opportunities for scholarships where donors have asked that priority consideration be given to students meeting certain demographic criteria (such as minority status, parent's place of employment, area of study, etc.)
Gender
Male
Female
Other
Are you a US citizen?
Yes
No
Please check your veteran status.
Veteran
Child of a Veteran
Grandchild of a Veteran
Spouse of a Veteran
Please check your status at the time of application.
I will graduate college this year
I will be an incoming freshman, graduating this year
I have attended college but have less than 32 college credit hours
I have attended college but have at least 32 college credit hour or more
I am a
GED
candidate with no college credit hours
What is your career objective?
Next
III. Essay
Your essay should be 300-500 words. You should address in your essay: your college goals and choice of major, what you intend to do with your education, and why a scholarship is important to you. Include any academic and non-academic accomplishments, personal characteristics, or experiences that make you uniquely worthy of scholarship consideration.
Essay
*
IV. Applicant's E-Signature
By signing the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.
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