Scholarship Application

Personal

First Name *

Last Name *

Email *

Cell Phone *

Mailing Street Address *

City, State *

Zip Code *

Birth Month *

Birth Day *

Birth Year *

Sex *

Educational

Cumulative Grade Point Average (GPA) *

Are you the first person in your family to attend college? *

School Name Currently Attending

School City & State Currently Attending

Awards & Activities

Separate items by Commas

Academic Honors

Non-Academic Awards

Membership Activities

Hobbies & Outside Interests

Extracurricular Activites

School Related Volunteer Activites

College Prospects

If you have decided on what college you will attend, please list school name

If not, List your Top 3 College Choices

Relation to HANO

If you answer 'Yes' to the first question, please complete this section, if not proceed to the next section

Is your parent or legal guardian an employee of HANO? *

Parent or Legal Guardian First Name

Parent or Legal Guardian Last Name

Include address if different than your own listed under the Personal section

Parent or Legal Guardian Mailing Address

City

State

Zip Code

Parent or Legal Guardian Home Phone

Parent or Legal Guardian Work Phone

Statement Of Accuracy For Students

I hereby affirm that all the above stated information provided by me is true and correct to the best of my knowledge. I also consent that if chosen as a scholarship winner my picture may be taken and used to promote the Housing Authority of New Orleans scholarship program. (Winner may waive photo due to unusual or compelling circumstances.) I hereby understand that if chosen as a scholarship winner, according to the Housing Authority of New Orleans policy, it is my responsibility to remit to HANO the appropriate information for my scholarship to be paid directly to my educational institution. I hereby understand I will not submit this application without all required attachments and supporting information. Incomplete applications or applications that do not meet eligibility criteria will not be considered for this scholarship.

Signature of Scholarship Applicant *

Signature of Scholarship Applicant Date *