5 for 6 Scholarship Application

If you see this don't fill out this input box.

First Name*

Last Name*

Student ID (LoLA #)*

Permanent Address (Street, City, State, ZIP)*

Date of Birth*

Phone*

Last Four Digits of SSN*

Email*

Program You Are Participating In Please Select ACE SCALE UP

College and Career Pathway You Are Persuing

Healthcare

Information Technology

Technical Trades or Skilled Crafts

Culinary

Hospitality

Please choose one.

Select the statement that applies to you. Please Select I have not yet earned a high school diploma or high school equivalency diploma or GED or HiSET. I have earned a high school diploma, high school equivalency diploma or GED or HiSET.

Select the statement that applies to you. Please Select I am attempting to earn my first 6 college credits. I have earned college credit in the past and I am requesting an exception to this requirement.

Write a brief essay answering the question, "How does continuing your education allow you to positively impact your community?"*

College Credit Disclaimer

Only answer the question below if you've already earned college credit.

If you have earned college credit in the past and are requesting an exception to this requirement, what is the reason? Please Select I was a prior recipient of Ability to Benefit funds. I am reattempting completion of my first six college credits. I am on academic probation but I have demonstrated academic success in noncredit classes during that time.

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