G.B. Winston Scholarship Application 2022

To be eligible you must: rank as a first-time graduating high school senior, be in pursuit of acceptance or already accepted for enrollment at a college or university; be a resident of Sangamon County; show proof of having maintained a “C” average during your junior and senior years or demonstrate possible completion in field of interest; i.e. vocational studies; and demonstrate financial need.

The application deadline is May 20, 2022. Applications can be completed online or on paper. Paper applications should be returned to: Springfield Urban League, Inc., Attention: Ashley Moore, 100 North 11th St., Springfield, IL 62703.

If you desire additional room for answering questions, please use a separate sheet.

If you have any questions while completing the application, please contact Ashley Moore, Springfield Urban League, 217-789-0830, x1129.

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* 1. TELL US ABOUT YOURSELF

Full Legal Name *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Email Address *

Phone Number *

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* 2. DATE OF BIRTH

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* 3. HIGH SCHOOL GRADUATE, WHAT YEAR?

Other (please specify)

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* 4. NAME OF SCHOOL

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* 5. PARENT/GUARDIAN INFORMATION

Name *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Email Address *

Phone Number *

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* 6. FAMILY GROSS INCOME FOR THE PAST YEAR

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* 7. NAMES/AGES OF OTHER CHILDREN DEPENDENT UPON PARENTAL SUPPORT

NAMES/AGES

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* 8. PLEASE INDICATE ANY FINANCIAL AID, SUCH AS SCHOLARSHIPS APPLIED FOR, GRANTS ETC. (Which you may have received while attending school - type of assistance, amount and year)

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* 9. LIST THE SUBJECTS YOU TOOK IN SCHOOL THAT HAVE BEEN ESPECIALLY BENEFICIAL TO YOU:

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* 10. LIST ALL EXTRACURRICULAR ACTIVITIES, CLUBS AND COMMUNITY ACTIVITIES IN WHICH YOU HAVE PARTICIPATED:

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* 11. WHAT ARE YOUR CAREER EDUCATIONAL OBJECTIVES?

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* 12. PLEASE LIST THREE ADULT REFERENCES (UNRELATED) THAT WE MAY CONTACT CONCERNING YOUR CHARACTER AND DEPENDABILITY. One reference should be your high school counselor.

Reference 1 (Name, Address, Occupation)

Reference 2 (Name, Address, Occupation)

Reference 3 (Name, Address, Occupation)

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* 13. SCHOOL PREFERENCE

NAME OF SCHOOL

ADDRESS

CITY/STATE

PHONE

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* 14. SCHOOL COST BY ACADEMIC YEAR (All fields are required)

Tuition

Room/Board

Travel

Books/Lab Fees

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* 15. HOW DID YOU LEARN ABOUT THE SRINGFIELD URBAN LEAGUE PROGRAM?

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* 16. ESSAY QUESTION: DESCRIBE HOW YOU HAVE DEMONSTRATED LEADERSHIP ABILITY BOTH IN AND OUT OF SCHOOL. (Must be 2 pages and double spaced)

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 17. SUBMIT YOUR UNOFFICIAL TRANSCRIPT HERE

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 18. I AM SUBMITTING MY INFORMATION, ESSAY AND UNOFFICIAL TRANSCRIPTS BY 5:00PM ON MONDAY, APRIL 18, 2022 TO RECEIVE FULL CONSIDERATION FOR THIS SCHOLARSHIP OPPORTUNITY.

Yes