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Student Financial Assistance Application

Name*

Address*

Email*

Phone*

Age*

Are you currently a student?

What school are you attending or planning to attend?*

Current Grade/Form *

Do you have an intended field of study? *

When will you graduate? *

Do you have a financial need? *

Yes

Please provide details of financial need *

Current financial status of your family *

Employment status of parents*

How do you intend to use this money? *Receipts will be required. *

What is the highest level of education achieved by your family? (Applicant)*

Less than High School

High School

Bachelors Degree

Masters + Degree

N/A

What is the highest level of education achieved by your family? (Parent)*

Less than High School

High School

Bachelors Degree

Masters + Degree

N/A

What is the highest level of education achieved by your family? (Siblings)*

Less than High School

High School

Bachelors Degree

Masters + Degree

N/A

What makes you the ideal candidate for this funding opportunity?*

List two references here along with their contact information. If you are currently in school, one of the references must be affiliated with your school.*

Please upload one letter of recommendation*

Please upload your most recent report card*

Please upload a photo of yourself. If you are a recipient of an award please note that your photo may be used on our promotional materials or on our website.*

Please describe any recent community activity. Note: All award recipients must participate in a community activity during the upcoming school year. This is a requirement for the scholarship award.*

Disclaimer: We may request proof that the funding you received was used for the intended purpose.

support@bernadettefrancisfoundation.org

Address

Bernadette Francis Foundation

P.O. Box 340555

Tampa FL 33694

United States

Florida 501(c)3 Not For Profit Organization

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