ZACHARY M. TOMPKINS MEMORIAL FUND
Scholarships
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Academic Scholarship Application
Personal Information
*
Indicates required field
Full Name
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Phone Number
*
(xxx) xxx-xxxx
Date of Birth
*
mm/dd/yyyy
Email
*
Academic Information
How would you like to send in your High School Transcript?
*
By this form
A
ll transcript submissions must be received no later than seven days after application submission. Please contact your school counselor/administrator for transcripts.
Transcript Upload
*
Max file size: 20MB
Only required if "on this form" was answered for the above question.
Name of High School
*
College/University Information
What college/university do you plan on attending?
*
To be eligible for this scholarship, you must have a college/university selected.
Selected Major
*
If undecided, please respond "undecided".
Have you received any other scholarships? Please list the name and amounts below.
*
We only ask this for legal issues.
Personal References
Reference #1
Name
*
First
Last
Phone Number
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Relationship
*
Reference #2
Name
*
First
Last
Phone Number
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Relationship
*
Personal Response
How have you made a significant impact on someone's life?
Response
*
The essay may be as long or short as you feel fit.
Terms and Conditions/Rules and Regulations can be found
HERE
I agree that all information submitted here is true and factual.
*
Yes
I have read and agree to the Terms and Conditions/Rules and Regulations of this contest.
*
Yes
I agree to receiving marketing and promotional materials
*
Submit Application
Scholarships
Previous Winners
ABOUT ZACH
EVENTS
STADIUM PROGRESS
MEDIA
News Articles
Photos
Web Links
VOLUNTEER
Contact