Scholarship Application

[contact-form to=’tbraxton@lazarusfoundation.org’ subject=’Scholarship Submission Form’][contact-field label=’Name of Student’ type=’text’ required=’1’/][contact-field label=’Name of Representative (i.e. social worker%26#x002c; guardian%26#x002c; clergy%26#x002c; school councilor)’ type=’name’ required=’1’/][contact-field label=’Street Address%26#x002c; City%26#x002c; State%26#x002c; ZIP’ type=’textarea’ required=’1’/][contact-field label=’Email’ type=’email’/][contact-field label=’High School Attended/Attending’ type=’text’/][contact-field label=’College Attending’ type=’text’/][contact-field label=’Grade Point Average (on a 4.0 or 10 scale)’ type=’text’/][contact-field label=’Family Income Per Year’ type=’text’/][contact-field label=’Describe any and all services you have done for your school or community.’ type=’textarea’/][contact-field label=’In 300-500 words%26#x002c; describe your financial need/difficulty and explain how you will make a difference with your college degree.’ type=’textarea’/][/contact-form]