Full Legal Name First Name * Middle Name * Last Name * Gender * Permanent Address Address * City * State * Zip * Date of Birth * Are you a U.S. Citizen * Cell * Email Address * Current Status (High School Senior, College Freshman, etc.) * High School Name * Address * City,State,ZIP * SAT or ACT Score * Cumulative GPA * Current College(if applicable) Name * Address * City, State, ZIP * Cumulative GPA * (if applicable) Student ID * College you will attend in the fall Name * Address * City, State, ZIP * Major * In submitting this application, I believe all of the above information to be true and complete. I certify that I am not currently receiving full funding for my education. I authorize The Arc to obtain and review my academic records. By submitting this application, I authorize The Arc to use my name and photo if I am selected as a scholarship recipient.All Scholarship information will be kept strictly confidential. Signature * Date * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20162017201820192020 Questions Please respond to the following questions. Attach your typed responses to this form. Please list your extracurricular activities from the last two years. (Indicate the dates you participated in the activities.) * (Indicate the dates you participated in the activities.)Files must be less than 2 MB.Allowed file types: gif jpg jpeg png txt pdf doc docx rar zip. List any significant awards or honors you have received during the last two years for academic or extracurricular achievements. * Files must be less than 2 MB.Allowed file types: gif jpg png txt pdf doc docx. Upload, email, or mail in all materials. All materials must be mailed in one packet. If you choose to email, it all must be in one email. The Arc of Cass County Higher Learning Scholarship 215 N University Drive Fargo, ND 58102 firstname.lastname@example.org ESSAY: * 1. Why have you chosen to pursue higher education? 2. What field of study are you interested in? Why have you chosen that particular field? 3. What have you done to prepare yourself for higher education? 4. If you were chosen to receive the Arc's higher learning scholarship, how would you use the funds? 5. List any other information you would like The Arc to consider in support of your application. Files must be less than 2 MB.Allowed file types: txt pdf doc docx. Transcript: * Please submit an official transcript including your most current semester with your application materials.Files must be less than 2 MB.Allowed file types: txt pdf doc docx. Eligibility Documentation: * Please submit medical or educational information confirming intellectual and/or developmental disability. (ex. physician's statement, Individual Education Plan, etc.)Files must be less than 2 MB.Allowed file types: txt pdf doc docx. College Acceptance Letter: * Please submit a copy of an acceptance letter or current enrollment documentation.Files must be less than 2 MB.Allowed file types: txt pdf doc docx.