EmailMe Form - New Black Leaders of America Scholarship

Name *

First Last

Email *

Phone *

### - ### - ####

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Date of Birth *

MM / DD / YYYY

GPA *

What type of post-secondary education institution are you applying to? *

Trade School

2 Year College Program

4 Year College Program

What school will you be attending? *

Semester Enrollment Date *

Fall 2019

Winter 2020

Fall 2020

Please upload your APS high school transcript or GED diploma. *

Please upload a response to the following question: What are your goals after graduating high school? (300 max word limit) *

Being a leader requires you to be a servant first. (1) How do you currently serve your community/behave as a leader? (2) How do you plan on serving your community in the future? (300 max word limit) *

Please print and sign the following form, then send a scanned copy to thebttproject@gmail.com:

https://docs.google.com/document/d/1w8NUREc9nQN0l-GENtufZIkAWRFQ_VBvD1cDgiCSEW4/edit?usp=sharing

We cannot review your application without this. *

I'm printing the document to scan and email.

I will not print the document.