Scholarship Application Form - Women Leaders in Action

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.).

Complete the form below to participate for this scholarship!

Deadline

The Application Period is Now Closed.

Personal Details

First Name*

Middle Name

Last Name*

Date of Birth*

Gender*
MaleFemale

Country of Origin*

Email Address*

Phone #*

Mailing Address

Street Address*

Street Address Line 2

City*

State / Province*

Postal / Zip Code*

Country*

Current Study Status & Intentions

Current Academic Status*

What Career do you intend to pursue?*

Level of Education*

Current GPA*

You Intend to Study*
Full TimePart Time

Anticipated Graduation Date*

School Name*

Please list any academic awards or scholarships that you would like to make the selection committee aware of

References

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

Reference 1

First Name*

Middle Name

Last Name*

Contact #*

Email Address*

Reference 2

First Name*

Middle Name

Last Name*

Contact #*

Email Address*

Supporting Documents

Please submit your Curriculum Vitae, essay, 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.

Curriculum Vitae & Essay*

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.