Read and Understand the Instructions. *

Yes, I have.

Name *

First Name

Last Name

Birthdate *

MM

DD

YYYY

Phone *

(###)

###

####

Home Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Are you a U.S. Citizen? *

Yes

No

Ethnic Origin

Hispanic

Non-Hispanic

Not Indicated

Race

White

Black or African American

Asian

American Indian, Alaskan Native Hawaiian, or Other Pacific Islander

Non-Resident Alien

What qualifying branch was your First Responder parent? *

Correction

Dispatch

EMS

Federal Agents (i.e. Border Patrol, Forestry Services)

Fire Department

Law Enforcement

Military, Security, Tow Truck Drivers and Loss Prevention

Nurses

Search and Rescue

Wounded Warrior

Contractors: An employee of any private company, when that employee provides direct material support to deployed forces and First Responders (Police, FIre, Paramedics) in the performance of their duties.

Status at the time of application:

I will graduate in May 2023

I will be an incoming freshman graduating high school prior to 2023

I have attended college but have less than 32 college credit hours

I have attended college but have at least 32 or more college credit hours

I am a GED graduate with no college credit hours

Are you a first generation college student?

Yes, I am the first among my parents or grandparents to attend college.

No, either my parents or grandparents have attended college.

Have you submitted an application for admission?

Yes

No

Are you or will you be a May 2023 high school graduate?

Yes

No

Would you like to be considered for a summer award?

May 2023 high school graduates are eligible for consideration for summer scholarships in addition to fall-spring awards. Accepting a summer award obligates you to attend in the following fall and spring.

Yes

No