Balot Family Scholarship Application

Page 1 of 5 - Student's Information

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Student's Information
Has the student been accepted to JPII? *
Name Name * First Last
Preferred Name *
Date of Birth Date of Birth * / MM / DD YYYY
Grade for 2018-2019 School Year *
Current School Name *
Grade Applying For: *
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Religion *

Religion I am a member of a Catholic church. I am not a member of Catholic church.
Church Name
Ethnicity *

Ethnicity Hispanic or Latino Not Hispanic or Latino
Race (check all that apply): *

Race (check all that apply): Asian American Indian / Native Alaskan Black / African American Hawaiian / Pacific Islander White Two or more races
Please indicate extracurricular activities you have been involved in or would like to be involved in at JPII (not all activities listed are currently offered).

Please indicate extracurricular activities you have been involved in or would like to be involved in at JPII (not all activities listed are currently offered). art Beta Club Debate Team drama / theatre arts music (chorus) music (orchestra) music (rock band) National Honor Society Spanish Club Quiz Bowl robotics Science Olympiad student government Young Life Other Other
Do you participate in any of the following sports? Note: not all listed are currently offered.

Do you participate in any of the following sports? Note: not all listed are currently offered. baseball basketball cheerleading cross country dance team football golf lacrosse soccer softball swimming tennis track & field volleyball wrestling
Please upload a recent photograph of the applicant. *

Attach Files
Save my progress and resume later
Enter Your Email Address *

A special link to resume the form will be sent to your email address.

Balot Family Scholarship Application

Page 1 of 5 - Student's Information

Student's Information