Scholarship Application Form

To be considered for this scholarship, you must be a senior high school student residing in New Jersey, intending to pursue a degree in the healthcare field, liberal arts or Science technology Engineering Math (S.T.E.M.). This application is free of charge.

Complete the form below to participate for this scholarship!


Submit your application and all required documentation by

May 27, 2022 at 11:59 PM EST

    Personal Details


    Mailing Address

    Current Study Status & Intentions

    You Intend to Study*


    Provide two referee names with full contact details. (One must be a school referee such as counselor, teacher or professor)

    Reference 1

    Reference 2

    Supporting Documents

    Please submit your resume, essay, school transcript and the application all together via email. Your essay should be 300-500 words. You should address in your essay: your college goals and choice of major, what you intend to do with your education, and why a scholarship is important to you. Include any academic and non-academic accomplishments, personal characteristics, or experiences that make you uniquely worthy of scholarship consideration.

    By submitting this application, you are certifying that all information is correct and that you are the person completing this application. W. L. A. reserves the right to keep any information submitted.