Long Beach Rotary Scholarship Foundation

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2019 Basic Application

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Student Information

U.S. Citizen/Legal Resident/DACA Recipient*
Student City*
Student Phone Type*
Student Lives With*

Family Income and Resources

Name

Upload a copy of the Expected Family Contribution (EFC) from the FAFSA Student Aid Report (SAR).*
or drag it here.

School Information

School Now Attending*
College planning to attend*
Camp Enterprise Participant
Interact Member

Essay Questions

Parent AND Student signature below indicates that you have verified the information requested on this application and consent to release this information to the Scholarship Foundation.

Photo Release*

Note: The information included on this application will not be released to anyone except by written consent of parent, or student if 18 years of age.  Ed Code 49075

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