Grant Request Form Grant Request Name * Address * Phone * Email * County of Residence: * Monroe Wayne Ontario Livingston Genesee Orleans Birth Date * If under 21, Parent/Guardian Name: Parent/Guardian Address - City, State and Zip Parent/Guardian Apt. # Amount Requested * $ Date Needed * Describe what your financial need is and how this grant will help continue your education. * Did you graduate from High School? * Yes or GDI/GED N.A. School Name * Graduation or High School Equivalency Diploma Date List any School Honors, Recognitions, Activities/Sports: Acceptance to College, School or Vocational Program 1. Name of Degree, Program, Certificate or License * 1. School or Institution Name * 1. Enrollment Date * 2. Name of Degree, Program, Certificate or License 2. School or Institution Name 2. Enrollment Date Enrollment * Full Time Part Time DocumentationPlease submit by mail copies or email PDFs to info@rocedufund.orga. Transcript from your last school year.b. The FAFSA formc. Proof of enrollment or an Acceptance Letter to the college or approved secondary program or vocational program.d. Two Recommendation Letters from persons identified below. Projected Graduation or Completion Date * Work Experience – if applicable 1. Company Name 1. Position 1. From (Mo/Yr) 1. To (Mo/Yr) 2. Company Name 2. Position 2. From (Mo/Yr) 2. To (Mo/Yr) If you have done any volunteering in your community or at school, please describe. What are your educational goals? How do you plan to use your education in the future? * References In order to be approved, please send two (2) Recommendation Letters. You may use an instructor, a school counselor or employer. Email the 2 letters to info@rocedufund.org 1. Name of School Reference * School * Position/Title * Phone Number * Email * 2. Name of Character Reference (Not a family member) * Address * Position/Title * Phone * Additional Information required: 1. You may be required to have an in-person, telephone or virtual interview. 2. You will be required to maintain contact with an assigned RocEduFund Mentor. 3. You will be required to provide verification at the end of the school term about your academic progress. By entering your name and submitting this form you are promising that the information entered into this form is true. Name * Name First First Last Last Date * SUBMIT APPLICATION If you are human, leave this field blank.
