Your Name (required)

Your Email (required)

Address (required)

City, State, Zip Code (required)

Phone (required)

Social Security Number (required)

Date of Birth (required)

*Please note: the applicant’s personal information will only be used for consideration of this Scholarship Application, and will remain confidential. The contents of this Application will not be shared by the Oscar Grant Foundation with any other organization with the exception of the organizations listed by the Applicant on this Application for purposes of verifying the information contained therein.

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EDUCATION
_____________________________________

High School (required)

Graduation Date (required)

Name and Address of Organization (required)

Nature of Community Service(s) performed (required)

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College
_____________________________________

Name of College/University at which you will matriculate in the Fall of 2021 (required)

Acceptance Letter from a 4-year College or University Attached (required)
YesNo
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REFERENCE
_____________________________________

Name (required)

Relationship (required)

Company/Organization (required)

Phone (required)

*Please list one professional reference and attach one letter of recommendation. Please note: the Applicant’s professional reference may not be related to the Applicant by blood or marriage

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DISCLAIMER and SIGNATURE
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Certify (required)
I certify that the answers are true and complete to the best of my knowledge. I understand that false or misleading information in my application would disqualify my application for scholarship.

Transcript (required)

College Acceptance Letter (required)

Letter of Recomendation (required)

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