2023 JSS Scholarship Application

Name:

Address:

Phone:

Email:

Name of Institution Currently Enrolled In:

State Institution is Located In:

Education Level:

Undergraduate Graduate

Degree Sought:

Academic Status:

Number of Credit Hours Completed:

Number of Credit Hours Remaining:

Cumulative GPA:

Expected Graduation Date:

Academic Activities:
Please list any relevant community/outreach programs that you have been or are enrolled in. Please include the following for each: program name, brief description, your specific involvement or impact with the program, and the dates you were active or participated.

Extracurricular Activities:
Please list any relevant community/outreach organizations or clubs that you have been or are a member of through your institution. Please include the following for each: name of organization, brief description, your specific involvement/status or impact with the group, and the dates you were active or participated.

Community Service/Volunteer Activities:
Please list any relevant community/outreach organizations or clubs that you have been or are involved with that are NOT affiliated with your institution. Please include the following for each: name of organization, brief description, your specific involvement/status or impact with the group, and the dates you were active or participated.

Honors and Awards:
Please list any honors or awards that you have received or been associated with through your institution or outside of your academic profile. Please include the following for each: name of honor/award, brief description, your specific involvement/status or impact, and the dates you were active or were a recipient.

Work/Military Experience:
Please list any relevant community/outreach work experience that you were/are compensated for. Please include the following for each: name of company/organization, brief description of what they do, your specific involvement/status or impact, and the dates of employment.

Reference Contact Name:

Reference Contact Email:

Reference Contact Phone:

Essay:
Please provide one short essay in response to the following questions: 1) What contributions have you made towards community service for the betterment of others? 2) Why do you feel community service is important and how can your involvement positively impact others as well as your own life goals?

Unofficial School Transcripts:
Please provide a copy of your unofficial school transcripts, listing classes completed and grades.

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