Giving back Student Scholarship Application To apply, it is required that you fill out the form below. Name of Requesting Individual** Name of Educational Institution to Be Attended** Institution's Tax ID #, if Known Mailing Address & Contact Information for Disbursement of Funds:Address (legal address)* City* State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip Code* Email* Phone*Is institution qualified by the IRS under section 501c3?* Yes No If you have served as an intern at Juneberry Ridge, please indicate when (enter dates) and your supervision’s name.Please explain purpose of funds, how they will be used, and nature of need.Will your need recur annually and if so, for how long? Please note that, IF grant is extended, an educational transcript will be required to indicate student is maintaining a 3.0 minimum GPA.Please explain how request aligns with Juneberry Ridge’s mission: “nourish, educate, and build a better future”:Please submit a high school or college transcript, a teacher’s/professor’s letter of recommendation, and your resume or “brag sheet”FileMax. file size: 50 MB.FileMax. file size: 50 MB.FileMax. file size: 50 MB.If there is a deadline by which funds must be awarded, please indicate: Note: Award notifications are generally made in the month following each calendar quarter. We encourage applications be made with this information in mind.Are You Human?*Sorry, these ones are must-haves.CommentsThis field is for validation purposes and should be left unchanged.
