Scholarship Application

Please Provide All Requested Information; incomplete applications will be rejected.
Additional information including Social security numbers and Income Verification will be required if you are selected as a Scholarship Recipient.
Deadline for submission is June 1, 2023

Your Education costs:

HighSchool Information

Parent’s information

Please be accurate a copy of last year family’s tax return, both returns if filing separately will be required for verification if applicant is chosen

List all those Excluding yourself, who will be dependent upon and supported by your parental income:

Click ADD to include additional dependants

Have you received any AIP/ICC support in the past?


“I do hereby certify that the information provided is true and accurate to the best of my knowledge.”