Undergraduate Scholarship

Give People HOPE HOPE

The Douglas J. Stearns Foundation is named after Douglas C. Jackson and family members.

APPLICATION FORM
READ ALL DIRECTIONS AND CHECK THEM BEFORE EMAILING APPLICATION
Submission Deadline May 15, 2024: Email to Joyce Jackson, Joycetulsa@outlook.com

Prefix

First Name

Middle Name

Last Name

Home Address

Phone

Mailing Address

Phone

SexMaleFemale

Ethnic OriginAfrican-AmericanBlackNative AmericanCaucasianHispanicAsian/Pacific IslanderOther

College Major Program

Institution Address:

Enrollment StatusFull TimePart Time

Anticipated graduation date

1. EDUCATION/TRAINING: (Submit an official or student transcript of all schools attended.)

DATES

2. EXTRACURRICULAR COLLEGE ACTIVITIES

DATES

3. PROFESSIONAL ORGANIZATIONMEMBERSHIP:

DATES

4. WORK AND VOLUNTEER EXPERIENCES: (within the last two years)

5. YEARLY FINANCIAL SUMMARY:

Attach a brief statement on your financial need to pursue college

No file chosen

7. REFERENCES:

LIST THE TWO REFERENCES BELOW:

1455 Pennsylvania Avenue NW Suite 400, Washington, DC 20004 | Email: info@douglasjstearnsfoundation.org