Pipeline to Success Scholarship Application

Student Name *
Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Mailing Address
if different from physical addressStreet AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Phone *
Parent Phone *
Additional Parent Phone if necessary
Name of High School *
Type of Post Secondary Education *
UniversityAccredited CollegeVocational/TechnicalCertificate Program
Address of Institution
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Name of Institution *
Describe any clubs, extra curricular activities, and/or clubs your participate in *
Describe your volunteer/community service activities. *
Upload proof of citizenship *Birth Certificate, Social Security, Green Card, Passport
Attach Proof of Acceptance
Attach Recommendation Letters if applicable
Attach Additional Documents if applicable
Essay Mike Scott took a leap of faith when he quit his job to start Mike Scott Plumbing. He was successful through hard work, a commitment to excellence, and perseverance. Describe what success and hard work means to you. You may also tell us about a time you took a leap of faith.
Upload Essay *PDF file preferred