Roger J. DiPaolo Bright Future Scholarship Application Scholarship Appliation – DiPaolo Bright Futures Personal Information arrowup6 First Name * Last Name * Date of Birth * Email * Home Phone Cell Phone * Preferred Method of Contact * SelectTextEmail Additional Contact Name (Parent/Guardian/Relative) * If we are missing info needed to send out your scholarship, list someone we can call to try to reach you should our direct attempts fail. Additional Contact Phone * Address arrowup6 Street Address Street Address Street Address Street Address City City State/Province State/Province Zip/Postal Zip/Postal Country AfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCôte d'IvoireCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCroatiaCubaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSaint BarthelemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Criteria for this scholarship REQUIRES AT LEAST ONE of the following. Please indicate all that apply: * Live in the Skeels or McElrath neighborhoods of Ravenna Actively involved in the Skeels-Matthews or King-Kennedy Community Centers Education Information arrowup6 Current School Cumulative GPA Future School Intentions Enroll in Trade School Enroll in Two-Year Technical/Community College Enroll in Four-Year College/University Intended Major Family Educational Background * I am in the the first generation in my family to pursue higher education My parent(s) or grandparent(s) continued with education beyond high school Other (please explain)Other (please explain) Extra-Curricular School Activities Add Activities? Yes No How Many? (up to 5) One Activity Accomplishments Year (Select all that apply) Freshman Sophomore Junior Senior Two Activity Accomplishments Year (Select all that apply) Freshman Sophomore Junior Senior Three Activity Accomplishments Year (Select all that apply) Freshman Sophomore Junior Senior Four Activity Accomplishments Year (Select all that apply) Freshman Sophomore Junior Senior Five Activity Accomplishments Year (Select all that apply) Freshman Sophomore Junior Senior Community Involvement and Volunteer Experience Add Experiences? Yes No How Many? (up to 5) One Activity / Organization Year (Select all that apply) Freshman Sophomore Junior Senior Two Activity / Organization Year (Select all that apply) Freshman Sophomore Junior Senior Three Activity / Organization Year (Select all that apply) Freshman Sophomore Junior Senior Four Activity / Organization Year (Select all that apply) Freshman Sophomore Junior Senior Five Activity / Organization Year (Select all that apply) Freshman Sophomore Junior Senior Essay arrowup6 Submit a brief essay (not to 500 words) on your career aspirations. * Demonstration of Financial Need The applicant’s financial need will be considered and it will be measured by the cost of the education as compared to the applicant’s financial resources. Please provide the Selection Committee with any comments regarding financial need and upload any supporting documentation that you feel would be helpful. File Upload arrowup6 File Upload Drop a file here or click to upload Choose File Maximum file size: 4.19MB No minimum grade point average (GPA) or letters of reference will be required. If you have documents supporting your application, you may include it here. E-Signature Printed Name * Date * * I agree to participate in a personal interview if needed * 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. Submit If you are human, leave this field blank. Δ
