RCJ Application — My Sisters Keeper Foundation for Women

The Raven C. Johnson Perseverance Scholarship Application

Name

First Name

Last Name

Date

YYYY

Email Address

Phone

(###)

###

####

Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Citizen Status

U.S. Citizen

Other

If other, please list.

Current School of Enrollment or Acceptance

(If selected, scholarship funds will be sent directly to this institution). Please include City and State.

Student Enrollment Status

Full Time (12+ credit hours)

Part Time

Student Classification

Freshman

Sophomore

Junior

Senior

Expected Degree Completion Date

YYYY

Major/Field of Study

Career Goals upon Degree Completion