2019 Capital City Pride Scholarship

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* 1. Contact Information

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 2. Academic History - High School

High School

Cumulative Grade Point Average/Scale

Address

City/Town

State/Province

ZIP/Postal Code

Website

Phone Number

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* 3. Academic History - College

College/University

Cumulative Grade Point Average/Scale

Address

City/Town

ZIP/Postal Code

Website

Phone Number

Short Answer: Please limit all of your responses to a total of no more than 150 words each

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* 4. What are your professional goals?

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* 5. What do you consider to be the most important issue facing the LGBTQ community today? Why?

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* 6. How will you continue activities directed toward this issue? Explain.

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* 7. How did you find out about the Capital City Pride Scholarship?

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* 8. Have you ever been arrested or charged with anything other than minor traffic offenses? Explain.

Essay: Please limit responses to 300 words for each question.

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* 9. Describe specifically what the topic of diversity and inclusion and LGBTQ means to you.

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* 10. What significant things have you done and/or accomplished to provide education and understanding of LGBTQ issues in your school and/or community? Document what makes your experience/efforts unique. Be specific and provide supporting details.

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* 11. How has being LGBTQ influenced or shaped your academic goals and prospective career?

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* 12. How do you plan to continue advocating for and supporting the LGBTQ community post graduation and do you believe you will be able to utilize your education to strengthen the LGBTQ community?

Additional Attachments:

Send the following to president@capitalcitypride.org:

·       List of extracurricular activities and community involvement. Include organization names and dates.

·       List work experience. Include organizations and dates employed

·       Official transcripts of classes and grades

·       Two letters of recommendation

Applicant Certification:

By my submission of this application to Capital City Pride, I certify that if I am awarded a scholarship, the proceeds will be used for the payment of school related costs at a the College / University where the recipient is enrolled.

I understand that the award of this scholarship will be publicized, and I expressly consent to my name being used as a scholarship recipient in any such publicity. Further, I agree that photographs taken at these events may be included in publicity.

I certify that the information submitted on the application is complete and accurate to the best of my knowledge. I understand and agree with my responsibilities as detailed above.