Scholarship Application First Name * Last Name * Your Email Address * Your Phone Number Birthday Address Line 1 Address Line 2 Locations * New YorkTampaMiamiAtlantaPhiladephiaNew JerseyOther Other Location * City State ALAKASAZCACOCTDCDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Have you been accepted to an accredited college or vocational school? (if not, you can still apply) * Yes No If yes, what is the name of the school? Most recent GPA What are some challenges you've faced over your lifetime and how have you overcome them? (100-500 words) * What have you done to give back to your community? Examples include: volunteering with your youth group, picking up trash on your street, helping a friend in need. (100-500 words) * * Little Nick scholarship recipients have big plans for their future. What do you hope to accomplish in your future and how will this scholarship help you to get there? (100-500 words) * Are you planning to pay for your school next year ? * Yes No What is your family's yearly household income ? * $200,000 or more$150,000 to $199,999$100,000 to $149,999$75,000 to $99,999$50,000 to $74,999$35,000 to $49,999$20,000 to $34,999Less than $20,000I have no idea Are you involved in any government subsidized program ? * Yes No Do you verify that all information given in this application is correct ? * Yes No Do you agree to have your name used in media and announcements should you be selected for a scholarship ? * Yes No If you are human, leave this field blank. Δ
