2021 Hispanic Youth Leadership Summit: Scholarship Consideration Form

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The Idaho Hispanic Youth Leadership Summit is a free one-day event for Idaho students (8th - 12th grade) to learn about post-secondary education and career pathways. The summit will give students the tools they need to successfully pursue postsecondary and career pathways, and enhance access to scholarship and financial aid opportunities. Attendees will meet representatives from Idaho colleges and universities. Through an interview process, Seniors in attendance will be considered for scholarships (scholarships are contingent upon acceptance to the awarding institution).

GENERAL INFORMATION

SENIOR APPLICATION

Student's First Name: *

Student's Last Name: *

Student's Preferred Name:

Date of Birth (mm/dd/yyyy): *

YYYY

Are you Hispanic/Latino or of Spanish Origin? *

Race (select all that apply):

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

Preferred Language (select all that apply): *

English

Spanish

Other:

Required

Student's Phone Number (Frequently used): *

Student's E-mail Address (Frequently used): *

Send me texts: *

Mailing Address: *

City: *

State: *

Zip Code: *

Parent/Guardian's Full Name: *

Parent/Guardian's Phone Number (Frequently used): *

Parent/Guardian's E-mail Address (Frequently used):

What is the highest level of education attained by either of your parent(s) or guardian(s)? *

Some School but No High School Diploma

High School Diploma or Equivalent

Some College but No Degree

Associate Degree

Bachelor Degree

Master or Doctorate or Professional Degree

Other:

Are you a dependent of a veteran? *

Have you or one of your immediate family members worked as a migrant or seasonal farmworker? *

STUDENT PROFILE

Are you an incoming senior (Class of 2022)? *

High School Name: *

High School City: *

Cumulative High School Grade Point Average (GPA): *

My enrolled programs (select all that apply): *

TRIO Educational Talent

TRIO Upward Bound

GEAR UP

Future Hispanic Leaders of America (FHLA)

Migrant Education Program

AVID Program

None

Other:

Required

First College Choice *

Second College Choice *

Third College Choice *

What is your intended college major/ career? *

Areas of Interest (select all that apply): *

Athletics

Dance/ Cheer

Greek Life (Fraternities & Sororities)

Honors College

Marching Band

Military Science/ ROTC

Study Abroad

Other:

Required

Preferred mode of communication (select all that apply): *

Email (Please remember to check your email regularly for updates).

Phone Call

Text

Required

Scholarships are contingent upon acceptance to the institution. *

I understand that this information is considered part of a student's education record. Further, I understand that by signing this release I am waiving my right to keep this information confidential under the Family Education Rights and Privacy Act (FERPA). I certify that my consent for disclosure of this information is entirely voluntary. I understand this consent for disclosure of the information is only for the Hispanic Youth Leadership Summit.

Confirm student's email address: *

PLEASE CHECK YOUR EMAIL REGULARLY FOR UPDATES!

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