Scholarship Application 2024 Please enable JavaScript in your browser to complete this form. - Step 1 of 3Name *FirstLastDate *Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeContact Phone Number *Email *Consent to being contacted *I consent to being contacted by phone or by email regarding this application.Legal Guardian's Name *FirstLastLegal Guardian's Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeLegal Guardian's Diverse Power Account Number (if applicable)Legal Guardian's Employer *Phone Number *Legal Guardian's EmployerPhone NumberALL documents listed below must be uploaded by the application deadline. Letters of recommendation must be included with this application. *High school transcriptAcceptance letter or other evidence confirming admission to an accredited college / university / or technical schoolLetter of recommendation from two non-relative adultsEssayOfficial proof of your SAT or ACT scoreHigh School Transcript * Click or drag files to this area to upload. You can upload up to 5 files. Please upload your high school transcript.Acceptance letter or other evidence confirming admission to an accredited college / university / or technical school * Click or drag files to this area to upload. You can upload up to 5 files. Please upload your acceptance letter or documents confirming admission.Letter of recommendation from two non-relative adults * Click or drag files to this area to upload. You can upload up to 5 files. Please upload your recommendation letters.Essay * Click or drag files to this area to upload. You can upload up to 5 files. Please upload your essay.Official proof of your SAT or ACT score * Click or drag files to this area to upload. You can upload up to 5 files. Please upload your SAT or ACT score(s).Are you a member of the Immediate family of any director of Diverse Power Foundation or any director of Diverse Power Incorporated? *YesNoMembers of the Board of Directors of the Foundation, members of the Board of Directors of Diverse Power or their immediate family are not eligible to receive any disbursement of monies from the Foundation. I certify *I certify that all information reported on this application is true and correct to the best of my knowledge. I certify *I understand that falsifying or misrepresenting information will invalidate this application. I certify *Should I be awarded a scholarship, you have my permission to use my photograph in Georgia Magazine.Applicant's Digital Signature *NextName *FirstLastAcademic PerformanceSimple GPA on a 4.0 Scale *Class Rank *SAT ScoreACT ScoreYou are required to provide an official copy of your SAT or ACT scores.Participation in Extracurricular ActivitiesExtracurricular activities * Click or drag files to this area to upload. You can upload up to 5 files. In a separate attachment, please separate activities into the following six categories: (Do not list activities on an annual basis or list any activity more than once. For example, do not list freshman chorus, sophomore chorus, etc.) • Educational/Academic • Community/Volunteer • Sports • Music/Art • Religious • Offices Held/Awards/RecognitionApplicationsCollege, University, or Technical School(s) to which you have been accepted or have applied:School Name 1 *Phone *Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEntry Date *Contact Person *Tuition per semester *---School Name 2PhoneAddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEntry DateContact PersonTuition per semesterFinancial Need Assessment (Confidential)Total adjusted gross income of legal guardians *Proof of income must be provided if requested.Number of family members residing in household *Number of family members presently attending a college, university, or technical school *Other factors which influence financial need *PreviousNextPlease select one option below regarding your 100-150 word essay. *Upload my essayType my essay below100-150 word essay on the following topic: “How My Education Will Benefit My Community” *100-150 word essay on the following topic: “How My Education Will Benefit My Community” * Click or drag files to this area to upload. You can upload up to 5 files. I'm not a robot * = Please solve the math problem above to proceed.PreviousSubmit Complete the online application or you may also download and print the physical application for submition.Mail to:Diverse Power FoundationAttention: School Grant OR P.O. Box 160LaGrange, Georgia 30241-0003
