Needham 9/11 Scholarship Fund

September 11th Scholarship Fund Application Form
Welcome to the application for the Needham September 11th Scholarship Fund.

The application period for the 2022-2023 school year is closed.

To be considered for an award for the 2023 - 2024 school year, please apply between April 1 - July 1, 2023.

If you have any questions, please contact me - kmumma@needhamco.com, +1 212.705.0293.

Many thanks and best regards, Kathleen Mumma
Applicant Information
Full Name *

First Name Middle Name Last Name Suffix
Student ID Number (if known)
(e.g. 123456789)
Birthdate: *

Month Day Year
Phone Number: *

Area Code Phone Number
E-mail : *
Where the confirmation will be sent to
Home Address : *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Name of the deceased:
Employer of the deceased:
Relationship of deceased to applicant:
If applicant is under 18:
Parent/Guardian Name:
Parent/Guardian Phone Number

Area Code Phone Number
Parent/Guardian E-mail
example@example.com
Education Information
Academic level to which this award will be applied:
Financial Aid Office Email *
example@example.com
Grade/Year: *
Education institution you plan to attend:

0/40
Your school's Financial Aid Office contact information: *

Attention To: (i.e. Bursar's Office, Outside Scholarships, etc)

Street Address

City State / Province

Postal / Zip Code Country
Financial Aid Office Phone:

Area Code Phone Number
Major/Field of Study:
Most recent cumulative GPA (please note our GPA threshold is 2.5):
Most recent grade transcripts

Upload a File

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Schools attended to date and degrees/ certificates received:
Extracurricular & Work Information
Upload your resume (if applicable):

Upload a File

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OR, list your extracurricular activities, civic and community involvement and hobbies here:
Please describe your recent employment history:
Will you work during the school year?
Financial Aid Information
Please list other scholarships and grants you have been awarded and their amounts (or any scholarships applied to):
How much student loan debt have you incurred to date?
Please indicate how you plan to finance your remaining education costs (loans, savings, gifts, etc):
Graduate student applicants only: did you rely on student loans to finance your undergraduate studies? If so, how much?
Personal Values & Goals
We appreciate the opportunity to get to know our scholarship recipients and to watch them progress! Please help us understand who YOU are and who YOU strive to be.
Below, please provide brief, specific examples of your accomplishments in the following areas: Work Ethic, Acceptance of Responsibility, Helping Others/Team Work.

Examples can be from any area of your life - home/family, school, sports or extracurricular activities, hobbies, work, church/volunteer/civic activities, etc.
Work Ethic:
Acceptance of Responsibility:
Helping Others/Team work:
Supporting Documents
All Applicants:

Please upload the supporting documents listed below OR send them to Kathleen Mumma via email, fax, or mail - all contact information listed at the bottom of the application.
Tuition bill or estimate

Upload a File

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Most recent Adjusted Gross Income (1st 2 pages of IRS From 1040)

Upload a File

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First-time applicants:

Please also upload or send the following documents.
Copy of birth certificate

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Copy of parent's death certificate

Upload a File

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Applicant E-Signature
By signing (typing my legal name) in the space below, I hereby certify that, to the best of my knowledge, all information within this application is true and accurate, and I will promptly notify in writing The Needham September 11th Scholarship Fund of any changes.
E-Signature: *
When you press the submit button, you will receive an email confirmation that your application was received. Please print or save for your records. Thank you!

Should you have any questions about the Needham 9/11 Scholarship, please contact Kathleen Mumma:

Email: kmumma@needhamco.com

Phone: +1 212.705.0293

Private Fax: +1 212.298.8357

Mail: Needham Asset Management, 250 Park Avenue, 10th Floor, New York, NY 10177
Should be Empty:

September 11th Scholarship Fund Application Form

Applicant Information

Education Information

Extracurricular & Work Information

Financial Aid Information

Personal Values & Goals

Supporting Documents

Applicant E-Signature