Check all the scholarships for which you are applying (Racine, WI):
Mary Lou & Arthur F. Mahone CEO Scholarship Mahone / Herzing University Scholarship Mahone / Carthage College Access Education Awards
Your Information
All fields must be completed on this scholarship application form. Place N/A in the field if the question does not pertain to your application. First Last Middle
U.S. Citizen or Permanent Resident? Yes No Ethnicity (Check all that apply): African American Native American Hispanic American Asian Caucasian Other
Date of Birth Gender Male Female Other
Address City State Zip code Phone Email
Father/Legal Guardian
Full Name (Last, First) Occupation Employer Phone Email
Mother/Legal Guardian
Full Name (Last, First) Occupation Employer Phone Email
# of Dependents in Family # of Dependents in College/Technical School
Educational Info
High School Attended Graduation Date Unweighted GPA Unweighted Class Rank ACT/SAT
List below the colleges to which you have applied and indicate if you have been accepted (One per line). Planned Major
Financial Info
Please provide as much detail as possible. All information is confidential.
Are you seeking or have you received other financial assistance (Scholarships, grants, aid programs)? Yes No If yes, how much will you receive each year? Do you plan to work during the school year? Yes No Indicate any unusual or large expenses during your high school career that you and your family have experienced. State nature and amount: Explain why you need financial assistance to continue your education:
Achievements/Activities
List any non-school activities or interests, special recognition such as awards, honors, scholarships, leadership positions, and participation. List number of hours and/or dates and years involved.
School Activities
List school and extracurricular activities such as music, yearbook, athletics, clubs and volunteer activities. Include number of years or hours and/or dates involved and leadership positions and awards, honors or scholarships received.
Employment
List part-time and summer employment; include employer and job title.
Personal Reflection
Tell us about a time when you were faced with an obstacle and what you did to overcome it. Include any special circumstances you wish considered.
References
List two references (Non-family member).
Name (Reference 1) Address Phone Relationship Name (Reference 2) Address Phone Relationship
Essay & Additional Materials
Please attach a one page essay (Times New Roman, 12 point font, double spaced). It should be a minimum of 250 but no more than 350 words on the following: What motivates you? What are your life goals, and how will a college degree help you achieve those goals?
Along with your essay, please upload a current copy of your official high school transcript. A photo is required only if you are selected, it will be requested at a later time and used for all publications.
*Only awarded recipients will be notified via phone and a letter*
Please upload all attachments separately.
Submission may take a few moments. After successful submission, you will receive a confirmation message and email to follow.
Essay: Official Transcript:
