Home
About
Grants
Scholarships
Donor Funds
Blog
Contact
Donate
Search for:

George L. and Genevieve D. Moore Family Endowed Scholarship – Application

Scholarship Application - George L. and Genevieve D. Moore Family Scholarship

Personal Information

First Name *

Last Name *

Date of Birth *

Email *

Home Phone

Cell Phone *

Address

Street Address

City

State/Province

Zip/Postal

Country

Background Information

Father's Name

Father's Occupation

Mother's Name

Mother's Occupation

Education Information

Current School

Cumulative GPA

ACT Score

SAT Score

College, University, or Technical College planning to attend

Intended Major

Annual Cost to Attend

$

Other Scholarships or Grants

Have you applied for a Pell Grant?

Yes

No

Amount

$

Have you applied for other scholarships or grants?

Yes

No

How Many? (up to 5)

One

Type

Scholarship

Grant

Name

Amount (If Awarded)

$

Two

Type

Scholarship

Grant

Name

Amount (If Awarded)

$

Three

Type

Scholarship

Grant

Name

Amount (If Awarded)

$

Four

Type

Scholarship

Grant

Name

Amount (If Awarded)

$

Five

Type

Scholarship

Grant

Name

Amount (If Awarded)

$

Financial Information

How do you plan to pay for the portion of your education not covered by grants and scholarships?

Current Work Information

Employer *

Position *

Start Date *

Average Weekly Hours *

Hourly Wage *

$

~ Past 12 Months Income *

$

Essay

Essay (not to exceed 500 words). Describe your views on leadership and character citing examples of your personal leadership ability and character. *

In order to be eligible to receive a George L. and Genevieve D. Moore Family Scholarship, the applicant must meet the below requirements

State that your DO NOT use tobacco in any form

I DO NOT use tobacco

I DO use tobacco

State that you earn an income (over 12 months) equal to, or greater than, the amount of the requested scholarship

I DO

I DO NOT

Printed Name *

Date Submitted

*

By submitting this electronic application, I certify that I reviewed the information and to the best of my knowledge it is accurate. The Committee will use this application to determine scholarship recipients.

Contact Information

P.O. Box 623
Kent, Ohio 44240
330-470-8950
info@portagefoundation.org

Hours of Operation

Monday - Friday 8 am to 4:30 pm Closed Major Holidays

Follow Us on Facebook

Facebook page plugin loading...