Scholarship Application – Pitt Chozen Foundation

Your Name (required)

Mailing Address (required)

Daytime Telephone Number

Email Address

Birthdate

Are you the first person in your family to go to college?
yesno
Name and location of High School/College attending:

(If your resume or activities sheet answers question 8, please attach and skip to Question 9.)

A. List any academic honors, awards and membership activities while in school:
B. List your hobbies, outside interests, extracurricular activities and volunteer activities:

Please provide the name and address of the college/university in which you will be attending:

On a separate sheet please type an essay (250 - 500 words) answering the questions below and upload to the link below:

Describe how your career goals and how this being awarded this scholarship will help you achieve them.

Statement of Accuracy for Applicant

By submitting this application, I hereby affirm that all the above stated information provided by me is true and correct to the best of my knowledge. I also consent that if chosen as a scholarship winner my picture may be taken and used to promote the Chozen’s scholarship program.

I hereby understand that if chosen as a scholarship winner, according to Chozen’s scholarship policy, it is my responsibility to remit the appropriate information for my scholarship to be paid directly to my educational institution.

I hereby understand I will not submit this application without all required attachments and supporting information. Incomplete applications or applications that do not meet eligibility criteria will not be considered for this scholarship.