Scholarship Application

State

What state do you live in?*

Please selectArizonaCaliforniaColorado ConnecticutFloridaIdahoIllinoisIowaNevadaNew YorkOregonUtahWashington

Your Information

Name*

First

Last

Personal Email Address*

Please use a PERSONAL email address, NOT a school email.

Phone Number*

Please enter your phone number with dashes. Example 801-345-6789 and not 8013456788

Parent/Guardian Information

Parent/Guardian Name*

First

Last

Parent/Guardian Email Address*

Parent/Guardian Phone Number*

Please enter your phone number with dashes. Example 801-345-6789 and not 8013456788

Mailing Address

Street*

City*

State*

Zip Code*

Apt # (if applicable)

School Information

High School*

Please enter the full name of your school. (example: New London High School, not New London. Western High School, not Western. Kearns High School, not Kearns)

LIA Teacher *

Please enter the first and last name of your LIA teacher. Please do not enter Miss, Mr., or Mrs. Example: Tom Johnson, not Mr. Johnson. Susan Brinkley, not Miss Brinkley

Cumulative GPA*

I will graduate high school in 2022 and plan to enroll in college in the 2022-2023 school year.*

Yes

Documents

Complete your application for a scholarship by submitting a pdf of your personal essay and a letter of recommendation. Please carefully review the scholarship application requirements before you submit these documents.

Personal Essay*

Please upload your personal essay in a pdf file format. Your essay should portray the “Trust In Me” theme. Your essay must be a maximum of 2 (two) pages, double spaced, using size 12 (twelve) font with 1” (one inch) margins.

Letter of Recommendation*

Please upload your letter of recommendation in a pdf file format. Your letter of recommendation should be from an adult with whom you have worked (ex: school administrator, employer, community representative, teacher, etc). Your letter of recommendation should not be written by a relative/family member.

Disclaimer and Signature

I certify that my personal essay is my own work and is in no way copied or plagiarized from any other source.

Signature (type full name)*

Thank You!

Please review your information carefully before submitting. LIA will not be responsible for incorrect emails or other incorrect information. Good luck!

SUBMIT

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