The Habitat Benton County Scholarship Fund : Programs : Habitat for Humanity of Benton County

2021 Habitat Benton County Scholarship Fund

You must either type or print all your answers neatly in ink. Application response may be sent via email to Cynthia@habitatbentoncountyar.org or mailed to Scholarship Application 1212 N Walton Blvd, Bentonville, AR 72712. Scholarship application and your letter stating why you need the funds and what they will be used for must be included. Homeowner must be in good standing with their Habitat mortgage.

Name

First Name *

Last Name *

Address

Country

Address Line 1 *

City *

State/Province *

Postal Code *

Email (Required)

Phone Number (Required)

Alternate Phone Number

What year did you receive a high school diploma or GED? (Required)

Name of High School (Required)

GPA (Required)

School Attending (Required)

Dates Attended

Start Month

Start Day

Start Year

End Month

End Day

End Year

Degree Earned (Required)

Applicant must register at a college, university, vocational or trade school for 2022-2023 year.

School Name (Required)

School Address

Country

Address Line 1 *

City *

State/Province *

Postal Code *

Major Field of Study (Required)

Expected Degree or Certification (Required)

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Are you currently working 20 hours or more per week?

Do you plan to work 20 hours or more during the school year?

CERTIFICATION ALL APPLICANTS: I am a Habitat for Humanity homeowner or child, age 21 or under, of a homeowner. I certify that the funds will be used for a GED, or higher education degree in conjunction with other funding sources. All information I have provided on this form is true and complete to the best of my knowledge. I agree to provide proof of the information on this application, if requested. Prior to the start of each semester for which scholarship money is requested, I will provide a copy of the course schedule and list of required textbooks for each course taken. I give Habitat for Humanity of Benton County permission to review information on this form and to contact school and/or college officials for additional academic information. If chosen for this scholarship award, I agree to provide proof of GPA to Habitat for Humanity of Benton County at each semester/quarter break for the Organization to determine future eligibility. Habitat of Benton County will make tuition checks payable to the school. Receipts are required for purchased books and computer equipment, testing, mileage, up to 200 miles one way, and other school fees. If chosen, I agree to submit a written paragraph to be published on the value of the scholarship award in my academic pursuits.

Digital Signature

First Name *

Last Name *

I acknowledge that by typing my name above, I am submitting my digital signature affirming that the information I have provided in the application is accurate and correct to the best of my knowledge.

Date

Month

Day

Year