Individual Scholarship Application

Who are you applying for?

Myself
A single school site
An entire program

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Mobile Phone *

Email *

Preferred Contact Method *

Email
Phone
No preference

If you are applying for yourself only, please tell us about yourself. Please include information about your school life, extracurricular activities, goals for the future, and your hobbies and interests. *

If you are applying for a single school site or a complete program, please tells us about your site/program. Please give us a complete snapshot of you. *

Please share your reasons for seeking Entrusted Legacy's support. *

Entrusted Legacy continually provides opportunities for scholarship applicants to give back to the commuity. Please indicate your willingness to participate in our community projects. *

Yes, I am wiling and interested in supporting an ETL project.
No, I am not able to support an ETL project at this time.

Please sign and date this application below. If you are a minor, please also provide the signature of your parent or guardian. When you click on the submit button you are verifying your signature and that of your parent or guardian if you are a minor.

Clear Signature