ABLA Foundation Scholarship Application
Name of Elementary school
Name of Middle school
Name of High Currently Attending school
Number of adults and children who are dependent on parents’ financial support:
Number of children dependent on parents’ financial support:
Number of family members attending college:
Please list the age of the children
Describe any existing conditions that are causing unusual financial expenditures for any dependents listed above. Ex: illness, dental work, support of family by only one parent, etc.
Please check approximate annual gross income in the home before deductions. Include all sources of income except earningsof minors in part-time employment.
$0 to $15,000
$15,001 to $30,000
$30,001 to $45,000
$45,001 to $55,000
$55,001 to $65,000
$65,001 to $75,000
$75,001 to $85,000
$85,001 to $95,000
$95,001 and above
Please list in order of preference:
First College Choice
Secord College Choice
Third College Choice
What are your career plans after college?
Name of Business
Average Hours Per Week
Scholastic Awards (Ex. Trustee, Honor Roll, History Award)
Athletic Awards (Ex. Track Team, Volleyball Captain)
Other Extra-Curricular Activities, Awards, or Honors(Ex. Band, Eagle Scout)
Hobbies, Talents, or Interests not listed above:(Ex. Piano lessons, youth groups)
Please respond to ONE of the topics listed below. This is your chance to present your best self to the Scholarship Committee. Attach your one page response to your application.
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