ADK Scholarship Application

Applicant First Name

Applicant Last Name

Date of Birth

Gender

Pronouns

School

Grade

Parent / Guardian First Name

Parent / Guardian Last Name

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Applicant Phone Number

Applicant Email Address

Parent / Guardian Phone Number

Parent / Guardian Email Address

Which program are you interested in attending?

In 200–500 words, please tell us why you are applying for this scholarship.