Scholarship Application

Step 1 of 6

Applicant Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Phone

Cell Phone

Parent/Guardian Information

Parent/Guardian Name

First Last

Parent/Guardian Home Phone

Parent/Guardian Cell Phone

Parent/Guardian Email

School Information

High School Attended

Do you have an after-school job?

Yes

Where do you work?

Extracurriclar activities

List any extracurricular activities in which you participate including, school, church, civic, social, community, athletic and/or other organizations. Include any and all offices held

Honors and awards

List any honors and awards received while attending High School

Talents, hobbies and other interests

List and talents, hobbies and other interests

What College or University would you like to attend?

What is your intended major and career goals?

Parent/Legal Guardian Affirmation and Consent

Parent/Legal Guardian Affirmation and Consent(Required)

By checking this box I affirm as the Parent/Legal Guardian I grant the consent listed below

As the parent or guardian of the applicant I give consent to him or her to participate in the MLKPF Scholarship program including attending the Parade Foundation Gala to
receive a scholarship award.

I further acknowledge and affirm that I have read all the materials and documentation contained in the MLK Scholarship application packet and understand the financial award process.

Parental Affirmation

First Last

Essay

Essay submission

Please submit an essay between 350 and 700 words on the topic, “What Dr. Martin Luther King’s life means to me and how I will live his dream”.

Transcript and Letter of Recommendation Upload

File upload

Drop files here or

Accepted file types: jpg, png, pdf, Max. file size: 512 MB, Max. files: 3.

Please upload your transcripts and TWO letters of recommendation with your application.

MEDIA RELEASE FORM FOR MINORS

Consent

I agree to the media policy.

I am aware that the Dr. Martin Luther King Parade Foundation, Inc. may videotape or photograph its service projects, programs and events. For photos or videos of applicants under the age of 18 to appear on the Foundation’s website, published materials, or media broadcasts, I understand that my written permission is required.

Further, I understand that information broadcast and/or published by the Dr. Martin Luther King Parade Foundation, Inc. may be accessed by the public at any time. Accordingly, I give my consent for my child's picture, voice, likeness, or work to appear in television broadcasts, video, film, photographs, recordings, and/or on the Dr. Martin Luther King Parade Foundation, Inc. website

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