Scholarship Application

"*" indicates required fields

Applicant Information

First Name*

Last Name*

Email*

Phone*

Street*

City*

State*

County*

Zip Code*

Name of High School*

Guidance Counselor Information

First Name*

Last Name*

Guidance Counselor Email*

Anticipated Graduation Date*

Membership Information

First Name*

Last Name*

Relationship to Applicant*

Street*

City*

State*

Zip Code*

How did you hear about the Scholarship program?*

Other

Extracurricular Activities and More Information

Leadership Roles/Athletics/Clubs*

Community Service/Philanthropy/Volunteering*

Honors & Awards*

Financial Need/Extenuating Circumstances*

Attachment and Submissions

In order for your application to be considered complete, please upload your video to YouTube.com and provide the YouTube link with your application submission below. Attaching the video file is optional. Please note: video file size cannot be larger than 30 MB. If you receive any errors submitting your application and attachments, please email: scholarship@gaheritagefcu.org.

Scan/Copy of High School Transcript*

Max. file size: 30 MB.

Letter of Recommendation*

Max. file size: 30 MB.

Additional Documentation if Desired

Max. file size: 30 MB.

YouTube Link*

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