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  • Membership Validation

    OK Membership Validation is required
  • OK Account # is required

About You

  • OK Student First Name is required
  • OK Student Last Name is required
  • OK Phone # is required
  • OK Home Address is required
  • OK City is required
  • OK State is required
  • OK Zip is required
  • OK Email Address is required
  • OK High School currently attending is required
  • OK High School current cumulative GPA (on a 4.0 scale) is required
  • OK College you plan/hope to attend is required
  • Have you applied?

    OK Have you applied? is required
  • Have you been accepted?

    OK Have you been accepted? is required
  • OK Intended field of study/Major? is required
    Optional OK My application qualifies for the Needs Based Scholarships is required
  • Choose one

    Optional OK Choose one is required
  • I certify that all information provided on this application and all supporting documents are accurate and complete. I understand that any misleading or false information will result in the disqualification of my application. If selected as a scholarship recipient, I understand that I (or my parent/guardian) will be asked to give full consent for the use of my name and photograph to be used for promotional and publicity purposes.
  • OK is required