Street Address, Town, Zip Code for Father/Mother *
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Graduating High School *
Obbligatorio
If you have a sibling in Grade 12, are they also applying for a Scholarship? *
Obbligatorio
If you have sibling in Grade 12 applying for a scholarship, please enter their name below. If you do not, please enter N/A. *
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If you have a sibling in College, are they also applying for a Scholarship? *
Obbligatorio
If you have sibling in College applying for a scholarship, please enter their name(s) below. If you do not, please enter N/A. *
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Name of College you will be attending. If undecided, enter Undecided. *
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If undecided, where did you apply? Please enter ONLY your top 3, separated with a comma . If you have decided, enter N/A. *
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Intended Major *
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Cost - Tuition/Room and Board & School Related Fees (Not to include books, supplies, insurance, travel etc.) *
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Adjusted Gross Income of parents or guardians as reported on their 2022 Tax Return. (If they have not yet completed their 2022 taxes, please use 2021's Adjusted Gross Income.) *
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Does the income reported above represent... *
Other Monies: Grants/Scholarships/Family Contributions - Please do not include loans. Enter total dollar amount only. (Ex. $15,000) *
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Where do you work and how long have you worked there? If you do not work enter N/A. *
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List your top three Extra Curricular Activities. Please separate them with a comma. If you don't participate in any, enter N/A.
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Combined Score for SAT. If you did not take SAT, enter N/A. *
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Combined Score for ACT. If you did not take ACT, enter N/A. *
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Verification information
I have checked this form for omissions and errors. To the best of my knowledge, the information reported is complete and accurate. Please check the appropriate box. *
Obbligatorio
Applicant Signature By typing your name below, you acknowledge that this is your digital signature indicating that the information you have provided is accurate. Applications will not be processed without your name entered below *
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As the parent of the applicant, I have checked this form for omissions and errors. To the best of my knowledge, the information reported is complete and accurate. Please check the appropriate box. *
Obbligatorio
Parent of Applicant Signature By typing your name below, you acknowledge that this is your digital signature indicating that the information you have provided is accurate. Applications will not be processed without your name entered below *
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You will receive an email confirming your responses to the email address supplied below.
Applicants Email address *
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If there are any extraordinary circumstances which you would like the committee to take into consideration, please send a letter of explanation to littletonscholarshiptrust@gmail.com
Una copia delle risposte verrà inviata via email all'indirizzo fornito.
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