VOLUSIA-FLAGLER RAINBOW ALLIANCE
2020-2021 Scholarship Application
INTRODUCTION—The Volusia-Flagler Rainbow Alliance, a GLBTQ service group, is pleased to offer scholarships for gay, lesbian, bisexual, and transgender students attending or planning to attend a college, university, or post-secondary vocational program between July 1, 2020, and June 30, 2021. The purpose of these scholarships is to promote and support the GLBTQ community in Volusia and Flagler counties and encourage leadership. It is expected that one or more grants in the $500-$1000 range will be awarded. The grants, made payable to the educational institution, may be spent on tuition, campus room and board, books or supplies. An applicant must be nominated (See item 1, below). Recipients will be chosen by the Alliance’s Scholarship Committee on the basis of academic achievement, financial need, and service to the Volusia-Flagler GLBTQ community. Preference will be given to applicants who are enrolled in a college, university or vocational school within Volusia or Flagler counties.
A complete application—typed, computer-printed, or hand-printed legibly in ink—should be mailed to Volusia-Flagler Rainbow Alliance, Attn: Scholarships, 3520 W. International Speedway Blvd., Daytona Beach, FL. 32124 no later than APRIL 1, 2020. Extra sheets may be attached for questions 13-16; be sure that your name appears on each sheet and that each response is numbered to match the corresponding question. The Rainbow Alliance may reject incomplete applications and applications not received by the deadline. Please retain a copy for your own records. Applicants must accept or decline an award by June 30, 2019.
1. Name and contact information (e-mail or telephone number) for the nominator:
NOTE: The applicant must be nominated. The nominator can be a faculty member, school official, counselor, adviser, officer of a school club or community organization, clergy person, employer, a neighbor, or someone else who knows the applicant well— but not a spouse, partner, parent, or other relative. The nominator is to provide a brief note (100 words maximum) telling: a) why the individual is being nominated, b) providing information to support or clarify the application and c) confirming that the applicant identifies as gay, lesbian, bisexual, or transgender. The nomination can be included with the application or mailed separately to the Scholarship Committee by the APRIL 1 deadline:
2. Full legal name of the applicant:
3. Gender or transgender identity:
4. Date of birth:
5. Last four digits of the applicant’s Social Security number (for ID verification only; this data will be kept confidential):
6. Citizenship (If not a U.S. citizen, copies of legal documents for residing in the U.S. are to be included: visa, green card, student visa, etc.):
7. Permanent legal address: (street)
(city) (state) (Zip) (nation)
8. Current mailing address (only if different from above):
9. Telephone number(s):
10. E-mail address:
11. Submit an official copy of a current transcript, or ask his/her school to submit a transcript to the Committee.
12. Attach a copy of the applicant’s federal application for financial aid.
ACHIEVEMENTS AND SERVICE:
13. List up to five academic or service prizes, scholarships, or other forms of recognition you have received in high school or college, or for community work. Briefly describe the award. (Examples: National Honor Society member; Dean’s List for four semesters; varsity letter in football ):
14. List and give brief details for up to five of the applicant’s most significant extracurricular activities and/or examples of volunteer service (Examples: Charity projects, church work, Big Brothers/Big Sisters; Pride Festival volunteering, etc.):
15. Summarize, in 200 words or fewer, the applicant’s interest in one or more gay, lesbian, bisexual or transgender issues or topics. Tell what the applicant has done to become knowledgeable about, and support, an aspect of GLBTQ culture, equality, or justice.
16. State a career goal, at least one personal goal (not work-related), and one goal having to do with the promotion and support of the GLBT community in Volusia and Flagler counties and/or encourage leadership in it that the applicant intends to achieve within the next one to five years. Explain briefly (200 words or fewer) why the goals are important to the applicant.
By signing and dating this application, I affirm that all information in this document is up-to-date and accurate to the best of my knowledge. I give the Rainbow Alliance permission to verify the information, and to use my name in its announcement of the scholarship awards.
Applicants who are under 18 should have this document co-signed by a parent or guardian.
(co-signer) ____________________________________ (date) __________