Scholarship Form

Scholarship Requirements That Students Must Follow

Students must have proof that they are underprivileged.
Students must be involved in some kind of community service.
Students must maintain outstanding grades.
Students should report grades every semester to a Minority Care International officer.
Students should meet often with Minority Care International staff to discuss his/her achievements while enrolled in school.
A student who receives low grades may have his/her scholarship revoked.

Scholarship Form

Last Name: *

First Name: *

Middle Name: *

E-mail Address: *

Complete Mailing Address: *

Permanent Mailing Address:

Educational Background

Elementary:

High School:

Scholastic Honors/Achievements:

College or University to be Enrolled this School Year: *

Program / Course: *

Financial Need:

Type: *

Expected Year of Graduation: *

Minority Care International is requesting this information in order to evaluate your application for scholarship assistance. No application will be considered without responses to all items on this application form and submission of all requested documents. Your submission certifies that the information presented on this application is true and correct. Falsified information will result in disqualification for assistance. Your submission of this application also authorizes the Minority Care International to publicize your name in connection with any scholarship award you may receive. In addition, your application also authorizes Minority Care International Selection Committee to check the references you have provided, to review your high school and college transcripts and to allow access to financial aid information supplied by the federal government.

Personal

PERSONAL ESSAY: Tell us about yourself and your interests. Also state why you feel you should receive this scholarship. (Address each of the following areas: financial need, career aspirations/goals, community service, etc.) Please include if you have any interest in a specialty area as some scholarships are for specific specialties. Your essay will be carefully examined and may be selected as it best matches the scholarship donor's criteria.

Statement about yourself:

Financial Need:

Career Aspirations/Goals:

Community Service/Civic Activities :

Other Comments/Information:

Terms: *

I AGREE

If I receive a Minority Care International scholarship, I understand that I must commit to comply with the Minority Care International Scholarship criteria that are stated on the website. If I cannot comply with the criteria, I understand that I may lose any Minority Care International scholarship awarded.

Signature: *

By TYPING MY FULL NAME, I certify that the answers and information set out above are true, accurate, and complete to the best of my knowledge. I acknowledge that if any answer or information is not true, accurate, or complete, I may not be considered for a Minority Care International scholarship.