1.First name , Last name, Email address, Phone number, date of birth, Gender, Street Address?

2.The Josher Foundation scholarship is awarded to the student that demonstrates the potential to make a positive impact on the community around them.  Do you feel this describes you?

YesNo

3.Have you been accepted to Middlesex County College or Rutgers?

Middlesex County CollegeRutgers University

4.Cumulative Grade Point Average (GPA):   (On a 4.0 scale) 

*There is no GPA requirement for this scholarship

5.Will you be full time or part time student?

Full time (12 or more credits)

Part time (Less than 12 credits) 

6.What major are you choosing?

7.Do you have reliable transportation?

8.What is your current job if employed? Write n/a if not employed.

9.Any extra curriculars? If none, why?

10.What does a successful life look like? Do not write more than a paragraph.