Online Scholarship Form – Underground Railroad Re-Run

Applicant Information:

Name*

Date of Birth MM/DD/YYYY*

Home Address*

City*

State*

Zip*

Primary Telephone:*

E-mail:

What school do you currently attend? (Enter high school or college as applicable)

a. Name

b. City

b. State*

b. Zip*

c. Phone number:

d. What is your current GPA? (email proof, eg transcript, report)*

What college will you attend this Fall semester?

City

State

Classification this fall semester:

What degree(s) are you pursuing?

Anticipated year of college graduation:

The Essay:
a. Research \"The Underground Railroad\"; then write a 250 to 300-word essay on how it inspires you to be all you can be, and help you overcome difficult challenges you may have to face in life. Submit your completed application (including essay) with a letter of recommendation and proof of acceptance or enrollment into a 2 or 4-year institution of higher education via email to [email protected]. Also, feel free to visit our website: www.ugrrr.org.

b. Neatly write, type, or print your essay on a separate sheet and attach to your application.

Complete your essay*

Certification Statement: By Checking the box below, I confirm that all of the information provided above and in the accompanying documents is true and correct to the best of my knowledge.

Check to Sign*

On

Underground Railroad Re-Run Scholarship Application