Scholarship Form

Step 1 of 5

Before you begin, you cannot save you progress and return to where you left off in this application. So, in order to complete this application, be aware:

You will need to provide your resume; up to three letters of recommendation; for Southern University System students, a copy of your most recent semester grades; transfer students, a copy of your transcript; for high school students, a copy of your transcript and your ACT or SAT score; and be prepared to answer the following question in 500 words or less: Why are HBCUs, like Southern University, still important and need our support today?

Please indicate up to two scholarships you would prefer to receive. You will be considered for all scholarships for which you are eligible.

While you will automatically be considered for all scholarships that match your qualifications, selecting up to two scholarships here allows you to express a preference for those you are most interested in. This does not guarantee selection but will help guide our decision process.

First Scholarship(Required)

Second Scholarship(Required)

Applicant's Personal Information

Name(Required)

First Last

SID#

Student U# is referenced in application.

What is your Permanent/Legal Address?(Required)

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

If you are still the dependent of your Parent(s)/Guardian(s), this is typically their address.

Parish or County of your Permanant Address(Required)

Please provide the name of the Parish or County as well as the state. For example, East Baton Rouge Parish, Louisiana or Harris County, Texas.

Local Address

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

Please provide your local address if you live on or off-campus if it is different from your Permanent Address. Otherwise, leave blank.

Your Telephone(Required)

Your Alternate Telephone

Your Email Address(Required)

Your Alternative Email Address

Your Date of Birth

Sex

Marital Status

Number of Dependents for you

Parent/Guardian Name 1

Parent/Guardian Name 2

Parent(s)/Guardian(s) Address

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

Please provide just the address for the Parent/Guardian Name 1

Parent/Gaurdian 1Telephone

Parent/Gaurdian 2 Telephone

Parent(s)/Guardian(s)' Employment

Number of Dependents for Parent(s)/Guardian(s)

Parent(s)/Guardian(s) Income Range

Before you begin, you cannot save you progress and return to where you left off in this application. So, in order to complete this application, be aware:

Please indicate up to two scholarships you would prefer to receive. You will be considered for all scholarships for which you are eligible.

Applicant's Personal Information

Applicant's Employment Information

Applicant's Educational Information

Applicant's Educational/Financial Awards

Please attach one of the following to the required fields below:

Signature

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