The UPLIFT Community Foundation, Inc.

               The UPLIFT Institute

Scholarship

Application

Personal Profile:

 

Name:                                                                                         Soc. Sec. #                                                                                                      

Current Address:                                                                                             State:                                          Zip Code:                                 

 

Permanent Address:                                                                                       State:                                          Zip Code:                                 

(If different than address above)

Phone:                                                                        Birthday:                                Male ______  Female               

Please provide your e-mail address, if applicable:                                                                                                  

If you are not a U.S. citizen please describe your VISA:                                                                                        

Parent/guardian name:                                                                                                                                                   

Address:                                                                                                      State:                                              Zip Code:                                 

Phone:                                                                                                        

 

 

Academic Profile:

 

High School or College/currently attending:                                                                                                                                         

Date of graduation:                                                                                    Current educational level:                                                

Please list your major:                                                                              Current G.P.A.:                                                                                

If you are currently attending college list any academic honors, achievements, or awards:                         

Year you will be attending college: _____________   Name of college you will be attending:                                 

Mailing address:                                                                                                                                                                                                      

City:                                                                                                              State:                                              Zip Code:                                 

List all extra-curricular activities, including sports, arts, music, etc.:                                                                  

 

 

 

 

 

 

The UPLIFT Community Foundation accepts applications for need-based scholarships between

February 1st and April 15th of the current calendar year.  Applicants must postmark their application

by April 15th of the current calendar year.   Please type or print neatly.  All questions must be answered.

 

Financial Profile:

 

List total family income (include alimony, child support, public assistance, or other sources of income):                                                                                                                                                                                                  

List total personal income (include employment, or other sources of income)                                                                                                                                                                                                                                                 

 

If you are receiving financial aid during this current academic year, please state the amount(s) and the source(s):                                                                                                                                                                               

                                                                                                                                                                                                  

If you have been turned down or denied financial aid or a scholarship during this current academic school year, please describe the circumstances:                                                                                                      

 

Projected School Year Budget:      

                                          Expenses                                                                     Resources

 

                      Tuition:                          $                                   Family                                                       $                       

                      Housing                        $                                   Personal                                                   $                       

                      Food                              $                                   Financial Aid (state or local)               $                       

                      Books                            $                                   Scholarships (applied)                           $                       

                      Fees                              $                      

                      Clothing & Laundry     $                      

                      Other Expenses ( Itemize) $            

 

                         Total Expenses      $                                                     Total Resources             $                       

 

 

Balance resources needed from other sources, including student loans:  $                            

 

Community Profile

 

How long have you lived in your community?                                                                                                             

Community activities/including dates and name of organization(s), your specific responsibilities and number of volunteered community service hours given.                                                                                         

                                                                                                                                                                                                  

                                                                                                                                                                                                  

 

Personal Statement

 

Please describe any personal circumstance, situation, or concern that the Foundation should know about that would encourage

a foundation to grant you a scholarship(s).                                                                                                                                           

                                                                                                                                                                                                  

                                                                                                                                                                                                  

                                                                                                                                                                                                  

                                                                                                                                                                                                  

 

Signature:                                                                                   Date:                                                                               

 

Approval By:                                                                                          Date:                                                                  

Corporate Office:

1776 K Street N. W., Suite #800

Washington, D.C.  20006

Phone: 202.291-4688, Ext. #4
Fax: 202.291-4632
Web URL:  www.upliftfoundation.org

Mailing Address:
Post Office Box 56484
Washington, D.C.  20040-6484

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