Youth Scholarship Application Form

Today's Date:

Name:

Email Address:

Application Deadlines

January 1, May 1 and September 1. If you submit an application between these dates, it will be considered during the next scheduled review period.

Scholarship Requirements

Applicant must have participated in a Diakon program (you did not have to complete the program to be eligible).
Refrain from illegal activity of any kind.
Provide documentation of acceptance or enrollment at a college, trade school or certification/training program (attach a copy with this application).
Have completed and submitted, F.A.F.S.A. form* – the standard fiancial aid form used to determine additional fiancial aid needed for college or trade school (attach a copy with this application). We may request other financial information, such as tax forms, if a FAFSA is not applicable.
* If you need assistance, contact your guidance office or your college’s financial aid office.
Fully complete application, including the two-page essay.
Provide documentation of expenses (receipt, college bill, renters agreement).
If you have received support from the Diakon Youth Scholarship before, you have the additional requirement of providing a copy of your transcripts showing a 2.0 GPA “C” average in order to be eligible to reapply.

Applicant Information

First Name:	Last Name:	Middle Initial:
Age:	Date of Birth:	Email:
Address:
Home Phone:	Cell Phone:	When is the best time to call:
Name of Parent/Guardian:	Parent/Guardian Phone:	Parent/Guardian Email:

Inquiry Details

In which Diakon program(s) did you participate?

Weekend Challenge Family Reunification & Preservation Weekend Alternative Behavioral Health Services Center Point Bridge Program Foster Care and/or Adoption Other -

Please provide the details of your request: Item requested (ex. tuition, books, rent)

Please provide the details of your request: Exact amt. requested for each item

Supporting Documentation

Please attach the following PDF documents:

Documentation of acceptance or enrollment (college/trade school)
Copy of FAFSA form (or other financial information)
Documentation of expenses (receipts, bills, rental agreements)
Transcripts (if reapplying - must show 2.0 GPA)

Drop PDF files here or click to browse

Only PDF files are accepted. You can upload multiple files.