2021 BVG Scholarship -1st Year
All requested information MUST be furnished completely. Failure to supply any part of the requested information voids application from consideration. Applications and other required information must be submitted no later than midnight, May 31, 2021.

I. Applicant's Information

II. Family Information

III. Education & Training

Click or drag files to this area to upload. You can upload up to 5 files.

IV. School Activities

List them below. If you have none, enter 'None'.
List all scholarships or grants received, grades 9-12.
List each, a description, and number of years of involvement.
List church participation, hobbies, special talents, community services, etc.
Other than 100 Black Men of Jacksonville, Inc., list other agencies and organizations + amounts.

V. Work Experience

List the job, your title, description, hours per week, and dates of employment.

VI. Parent's Confidential Declaration Of Financial Need

Parent Information

Must be accompanied by copy of current FAFSA EFC STATEMENT
Click or drag a file to this area to upload.
Click or drag a file to this area to upload.
A recent black & white photo of the applicant for publicity purposes. Must be head and shoulder at least 2” x 2 1/2”.

VII. Certification

I hereby make application for one of the 100 Black Men of Jacksonville, Inc. scholarships and submit the above information to assist the Scholarship Committee in evaluating my candidacy, and certify that:

1. All the information submitted in this application is true and correct;

2. I will use any funds received from the J100 only for the propose of paying expenses for my college education;

3. I will notify the J100 immediately if there should be any interruption in my plans for continuing my education this coming year.
Sign this form with your mouse or finger.