Pay Back to Go Forward Scholarship

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Please complete and submit this application to be eligible for PBGF tuition funding.

Email *

First *

Middle *

Last *

Maiden Name

Birthdate *

YYYY

Phone *

Term *

Please select the anticipated term of enrollment

Summer I 2020

Summer II 2020

Fall 2020

Required

Degree *

Please enter the degree or major you are pursuing.

Loans *

Are you currently relying on student loans to pay your tuition and fees?

Applied for Scholarship *

Have you applied for or been awarded any other scholarship or financial funding for college tuition?

Yes

Full-time Status? *

Please indicate whether you plan to attend full time or part time.

Full time with 12 or more credit hours

Part time with 9

Part time with 3 - 6 credit hours

Not sure

Required

Employed?

40 or more hours per week

20 - 39 hours per week

Less than 20 hours per week

Unemployed

Clear selection

FAFSA *

Have you submitted the FAFSA (Free Application for Federal Student Aid)

Clear form

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