Scholarship for Adults Application | Assistance League – Montgomery County

2025 Scholarship for Adults Application

Assistance League of Montgomery County
General Information
Current Date*
MM slash DD slash YYYY
Full Name*
First Middle Last
Email*
Cell Phone*
Home Phone
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
What is your marital status?*
- Married
- Single
- Divorced
Please indicate below your highest level of education completed, along with the date:*
Highest Level of Education Date Completed
Are you a resident of Montgomery County?*
- Yes
- No
Are you the "Head of Household?" (You can claim Head of Household if you are unmarried, having cared for a dependent for over half a year, and paid more than half the cost of maintaining a home.)*
- Yes
- No
Please list below your dependents (persons for whom you provide at least 50% of their financial support).
Name Age Relationship to Applicant
Name Age Relationship to Applicant
Name Age Relationship to Applicant
Name Age Relationship to Applicant
Are you a U.S. citizen?*
- Yes
- No
Education Information and Career Goals
Do you have an Associate Degree?*
- Yes
- No
If yes, complete the following information.
Date Earned Major College/University
Have you applied for this scholarship before?*
- Yes
- No
If yes, complete following information.
Date(s) Applied for Scholarship
Do you have a four-year degree?*
- Yes
- No
If yes, complete following information.
Date Earned Major College/University
Name of Texas public college/university you are attending (or at which you have been accepted).*
Student ID No.*
Location of college/university*
Major*
Current GPA*
Planned Course of Study*
Anticipated Completion Date*
What is your career goal?*
Are you working while getting your education?*
- Yes
- No
If yes, complete following information.
Current Employer Position Hours per Week Previous Employer Position Hours per Week
If you are not working, why not?
Financial Information
All students are required to complete the Free Application for Federal Student Aid (FAFSA) available December 2024. If known, provide the Student Aid Index (SAI) number on the Assistance League of Montgomery County scholarship application. You may submit your application without the SAI number but you must provide that number at a later date.
SAI Number
Approximate Annual Household Income. Include employment, savings, government assistance, savings, child support, loans, and scholarships. (Multiple any monthly amounts times 12.)*
Please list all sources of your Annual Household Income (employment, savings, government assistance, savings, child support, loans, and scholarships.*
What are your total household expenses? Include housing, utilities, food, child care, medical, transportation, tuition, and books. (Multiple any monthly amounts times 12.)*
Please Note:
Assistance League of Montgomery County will not divulge any information provided on this form to any other person or entity without the applicant's specific written consent. An online or personal interview with the Scholarship Committee members will be required. A convenient date and time will be arranged for both applicant and members of the Committee.
Essay #1: Write approximately 500 words in which you give detail about each of the following: 1) The impact this scholarship would have on your education, from a financial standpoint; 2) Any special personal or family circumstances affecting your need for financial assistance; and 3) How you plan to finance your education separate from scholarships.*
E-Signature
By submitting this application and checking the certification box below, I certify that the information included in this application is true and correct to the best of my knowledge. I authorize release of information to confirm and/or verify the contents for scholarship purposes only. In addition, I give Assistance League of Montgomery County permission to publish in print, electronic, or visual format the likeness or image of me. I waive any rights of compensation or copyright ownership thereto.
Certification:*
- I certify the information as stated as above
Submission Instructions
All applicants must mail or hand carry to the Assistance League Thrift Shop the following documents by or before the application deadline - Friday, May 30: 1. FAFSA Student Aid Report (SAR). If the applicant has submitted the SAR in the past, he/she does not have to resubmit it. 2. College Transcript demonstrating a 2.5 or higher Grade Point Average (GPA). 3. Should an applicant be awarded a scholarship, he/she will be required to mail or hand carry a copy of his/her class schedule as proof of enrollment. Scholarship funds will not be sent to the college or university without a class schedule. Mail or hand carry documents to: Assistance League of Montgomery County, Attention: Lana Sultz, 126 North San Jacinto Street, Conroe, TX 77301. When you have completed this application, click the "Submit" button below. ALL APPLICATIONS MUST BE SUBMITTED ELECTRONICALLY BY FRIDAY, MAY 30, OR THEY WILL NOT BE CONSIDERED, AND ALL REQUIRED DOCUMENTS MUST BE MAILED OR HAND CARRIED TO THE THRIFT SHOP BY FRIDAY, MAY 30, OR THE APPLICATION WILL NOT BE CONSIDERED.
Questions
Should you have any questions, please send an email to the Scholarship Team Leader at almc.scholarship@gmail.com
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