Scholarships

Scholarship Application Form 

Submission of completed Essay and Application Form must be received via email to:

SaveAcworthHistory@gmail.com by 11:59 PM on March 31

Applicant’s Name ______________________________________________________________________________________________________________

Mailing address________________________________________________________________________________________________________________

Email Address_________________________________________________________________________________________________________________

Telephone ____________________________________________________________________________________________________________________

Student Signature & Date_____________________________________________________________________________________________________

Name of Applicant’s Parent/Guardian_________________________________________________________________________________________

Parent Guardian address (if different from student)___________________________________________________________________________

Parent Phone Number & Email ________________________________________________________________________________________________ 

Parent Signature & Date ______________________________________________________________________________________________________

Applicant’s High School ______________________________________________________________________________________________________

College or University you plan to attend _______________________________________________________________________________________

Intended Major/Program of Study_____________________________________________________________________________________________