Scholarship Application

First Name

Last Name

Date of Birth required

Phone

Street Address

City

Region/State/Province

Postal / Zip code

Education Status

School / GED Program Name

Expected / Actual Graduation Date required

Where you plan to enroll

City of School / Program

Enrollment Date required

Enrollment must begin within 6 months of receiving the award. Scholarship funds may be used for tuition, books, fees, or other educational expenses

Intended Field of Study or Career Goal

Connection to Gun Violence

How have you been personally impacted by gun violence? Required

Survivor of gun violence

Family member of a gun violence victim

Witness to gun violence

Loss of a loved one due to gun violence

Resident of a community heavily impacted by gun violence

Participation in trauma recovery or violence intervention programs

Advocacy or volunteer work related to gun violence awareness

Other (please describe below

Describe your connection here..

Personal Essay

Please describe your full experience in the Personal Essay. Graphic details of your experience are never required. In your essay, please address all four of the following: 1. Your personal connection to gun violence and how it has shaped your life. 2. How you have demonstrated resilience and personal growth. 3. Your educational goals and what you hope to achieve. 4. How you plan to contribute to building a safer, stronger community.

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Allowed: PDF, DOC, DOCX, XLS, XLSX, PPT, PPTX, TXT, ODT

Letter of Recommendation

A letter of recommendation is required from a teacher, school counselor, mentor, community leader, or employer.

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Allowed: PDF, DOC, DOCX, XLS, XLSX, PPT, PPTX, TXT, ODT

Recommender's Full Name

Recommender's Last Name

Title / Role

Organization / School

Phone Number

Recommender's Email

Proof of Eligibility — Supporting Documents

Official or unofficial high school transcript (required for graduating seniors)

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Allowed: PDF, DOC, DOCX, XLS, XLSX, PPT, PPTX, TXT, ODT

Enrollment verification / senior status letter from school

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Allowed: PDF, DOC, DOCX, XLS, XLSX, PPT, PPTX, TXT, ODT

GED completion certificate or official documentation (required for GED recipients

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Allowed: PDF, DOC, DOCX, XLS, XLSX, PPT, PPTX, TXT, ODT

Optional Supplemental Materials

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Allowed: PDF, DOC, DOCX, XLS, XLSX, PPT, PPTX, TXT, ODT

Certification & Signature

By signing below, I certify that all information provided in this application is true, accurate, and complete to the best of my knowledge. I understand that any misrepresentation may result in disqualification or revocation of the award. I grant the JB White Foundation permission to use my name and general story (without identifying details) for scholarship promotion purposes, unless I indicate otherwise below.

Applicant Signature

Thanks for submitting your application. We will be in touch with you shortly! If you have any questions, please email Jude Voss at jbwhitefoundation@gmail.com