Scholarship Application

Scholarship Application
Instructions:
1. DO NOT leave any item blank. Only completed applications will be accepted.
2. Keep a copy of your application for your records.
3. Attach copy of your college transcript.
Criteria:

1. In order to meet these criteria, you must be a Resident of New York City.
2. Must be a full-time student enrolled in a 2 or 4-year undergraduate program or a high school senior.
3. Must have a GPA of 2.5 or better/High School a B average or better.
4. Two (2) signed letters of recommendation (from non-relative) must be attached to the application.
5. Demonstrate financial need.
Applicant Data
Last Name:
First Name:
Middle Initial:
Address:
Street Address:
Complete Street Address
Apt #:
City:
State:
ZIP Code:
Telephone or Cell #:
Alternate Telephone #:
Email Address:
example@example.com
Date of Birth:
U.S. Citizen Permanent Resident
The Elite Ones Organization, Inc. is a fully registered non-profit organization.

Educational Data
PART A
Name of College:
Major Field of Study:
Dates Attended:
Number of Completed Credits:
Graduation Date:
PART B
Projected School of Acceptance:
Projected Field of Study:
Years You Will Attend:
Credits Registered For:
In a short paragraph, give us some background about yourself, part-time or volunteer work you have held, your extracurricular activities, and organizations with whom you may be affiliated.

CONTACT INFORMATION

PARENT or GUARDIAN DATA (Please indicate with whom you reside)
Name of Mother:
Name of Father:
Name of Guardian:
Address:
Street Address:
Complete Street Address
Apt #:
City:
State:
ZIP Code:
Home Phone #:
Cell Phone #:
Other Address If Different From Above:
Street Address:
Complete Street Address
Apt #:
City:
State:
ZIP Code:

Weekly, Bi-Weekly or Monthly Earnings :
PLEASE ATTACH COPY OF PAYSTUB
NOTE:

Please submit the completed application to the address indicated or email us at info@eliteoneskids.org

The Elite Ones Organization
393 East 96th Street
Brooklyn, NY 11212
Attn: Sherma Richards

If you are selected for a scholarship, you will be notified via phone or email.

By signing this application, I authorize The Elite Ones Organization, Inc. to make inquiries related to the information provided. I am also aware that any false information provided in this application shall be null and void and becomes totally disqualified.
Signature of Applicant:

Clear
Applicant Name (Print):
Date:
DISCLAIMER

Information provided on this form will be kept strictly confidential and will only be used to determine the scholarship award.
The Elite Ones Organization, Inc. is a fully registered non-profit organization.
Should be Empty: