Student Name First Last Student's Birth Date* MM slash DD slash YYYY Entering Grade* School Year*2021202220232024202520262027202820292030Parent Contact InformationParent 1Parent 1 Name* First Last Parent 1 Phone*Parent 1 Email* Parent 2Parent 2 Name First Last Parent 2 PhoneParent 2 Email Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code To be completed by parents:Please explain your need for this financial assistance and how this scholarship will benefit your family.*To be completed by students:Please describe activities in which the student currently participates, as well as those from the past.*Church activities, sports, arts, clubs, service projects, etc. may be included.