Email Address:

Please Re Enter your Email Address

First name:

Last Name:

City:

State:

Are you currently enrolled in postsecondary education (college, university, etc) ? Yes No

If so, how many credit hours have you completed?

What is your major or field of study?

Please take a moment to write a few lines about your self. You may discuss your goals, hobbies, jobs, or anything else you think somebody would like to know about you.

Do you have a personal website you'd like for us to see ("YourName.com", MySpace, Facebook, etc) ?

Please explain how the Dedication for Education scholarship would assist in obtaining your college degree. Discuss any extraordinary financial hardships you may have incurred.

Please double check your entries and then press the "submit" button to submit your application.

Your email address will be added to our mailing list so that we may provide you with information regarding the status of your application, as well as future scholarship announcements.