Scholarship Test

Applicant's Name*

Address*

City, State, Zip*

Your Phone*

Your Email*

Social media contacts (optional)

Date of birth*

Father's Name*

Mother's Name (include maiden name)*

Description of Italian heritage* (eg: (grand-)father/mother immigrated from anytown, Italy) :

Name/Location of 2018/19 High School / College *

GPA*

Class Rank*

Awards/Honors Received:

Extra-curricular Activities:

Community Service Activities:

Name/Location of 2019/20 College*

Major(s)*

Upload your official school transcript. (.doc, .docx, .pdf format only. 1MB max.)

Upload your narrative essay. In approximately 500 words, please explain how being an Italian–American has impacted your life. The essay must be typed in 12-point font and double spaced.(.doc, .docx, .pdf format only. 1MB max.)

Upload your letter of recommendation from a recent teacher.

By signing this application I affirm the information provided to be truthful.

Digital Signature*

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