SCHOLARSHIP APPLICATION


This scholarship awarded by Great Young Society II and TLC pediatrics represents our commitment to applauding academic excellence in those students who reside in the Prince Georges County Maryland area. This scholarship was established to provide financial assistance to well-deserving students with a particular emphasis in STEM.

An applicant must:

- Have demonstrated leadership and academic skills

- Have been active in school and community activities

- Have the ability to express goals and aspirations in an essay

-Not have received a Great Young Society Scholarship previously

- Be a patient of the TLC Pediatric practice for a minimum of two (2) years prior to application submission.

* 1. Parent/Guardian Name (First, Last)

* 2. Applicants Name (First, Last)

* 3. College/University Name, Billing Address

* 4. How many years have you been a patient with TLC pediatrics?

* 5. High School Name, Address, Graduation Year, G.P.A

* 6. Home Address (City, State, Zip-code)

* 7. Phone Number

* 8. Email Address

* 9. A SHORT AUTOBIOGRAPHY

Include information about:

- Your educational experiences

- Your special skills and talents

- Your school activities

- Your community activities

- Your goals and why have you made these choices

- Other scholarships or awards you have received

Cut and Paste your short answer in the text box below


Contact information: Jesse Chittams
Phone: 240-274-2464
Email: greatyoungsociety@gmail.com

INCOMPLETE AND LATE APPLICATIONS WILL NOT BE CONSIDERED.
ALL DECISIONS ARE FINAL FROM THE SCHOLARSHIP COMMITTEE.
RETURN THE COMPLETED APPLICATION BY JULY 15, 2017.

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