ACADEMIC HONORS SCHOLARSHIP INFORMATION FORM

This form should be completed by the student applying for this scholarship.

Student First Name *

Student Last Name *

Parent First Name *

Parent Last Name *

Parent Email Address *

Parent Phone Number (ex. 954-123-4567) *

Please upload an extracurricular resume or list of extracurricular activities that you have been involved in since grade 6.

We are eager to learn more about you. Please share a song, protagonist in a book or character in a movie that describes you. Tell us why! *