Athens StepUp Scholarship Application DEADLINE: TBA Please compile a 500 word essay explaining why you should be a recipient of the Athens StepUp Scholarship Program. Mail the application along with your essay to: Athens StepUp Scholarship PO Box 49926 Athens, Georgia 30604 or Email your essay and application to: [email protected] Please print clearly and don't forget to sign the form.

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Athens StepUP Student Scholarship Application Student Name:____________________________ Date:_______________ Address: ________________ City:_________ State: ___ Zip Code: _______ Phone: ___________________ Email:____________________________ Circle one:

female

male

High School you attend:________________ Graduation Year*:_________ College/school at which I have been accepted (or date when you will know) _____________________________________________________ *Please check this box if you have been accepted into a program where your senior year of high school is also your freshman year of college. Parent/Guardian Email/Phone :__________________________ List three persons from your school/community/organization (one of which must be a contact person for your community service), who would be references for you. Please notify these people that you have listed them for this purpose and provide contact information, i.e., phone, email, street/city address, organization. 1._________________________________________________ 2._________________________________________________ 3._________________________________________________ My signature below indicates that I have read and understood the terms of this scholarship and the information provided above is true to the best of my knowledge. Student Signature: ____________________ Date: _____________ Parent/ Guardian Signature:______________________ Date:______

Athens StepUp Scholarship Application Athens ...

StepUp Scholarship Program. Mail the application along with your essay to: Athens StepUp Scholarship PO Box 49926 Athens, Georgia 30604 or Email your ...

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