SOUTH HOLLAND BUSINESS ASSOCIATION FOUNDATION

SCHOLARSHIP APPLICATION

PERSONAL INFORMATION

Full Name

Home Address

Campus Address

Home Phone

Campus Phone

Cell Phone

Date of Birth

Month

Day

Year

FAMILY INFORMATION

Parent/Guardian/Spouse #1

Name

Occupation

Employer

Parent/Guardian/Spouse #2 (Optional)

Name

Occupation

Employer

What company are you connected to that makes you eligible for this scholarship?

SCHOOL INFORMATION

(Complete this section only if you’re a current 8th grader, high school senior, or a college student who has completed a minimum of 24 credit hours.)

Elementary or High School(s) attended:

Contact Name of Principal or Teacher:

Date of Graduation:

ACT Composite Score:

Grade Point Average:

SAT Composite Score:

COLLEGE INFORMATION

Name of College/University Currently Attending:

Address:

Course of Study:

Number of Hours Completed:

Cumulative Grade Point Avg.:

Anticipated Date of Graduation:

School ID Number:

EMPLOYMENT HISTORY

(Complete this section only if you have graduated from high school within the last 4 years.)

Have you been employed in any summer or part-time jobs during your high school or college years?

Yes

If so, please list them with the corresponding Dates, Job Title/Type, Employer, and Number of Hours per Week:

List and describe any extracurricular activities, leadership roles, awards, and hobbies from high school and/or college:

Please list any additional information you believe is relevant to your scholarship application:

Must submit a Personal Statement (250 words or less): Why is this scholarship important to your personal and career goals?

Provide One Letter of Recommendation from a Teacher, School Advisor, or Principal

Kindly arrange to have your elementary school (8th graders), high school (graduating Seniors) or college transcripts (college students who have completed a minimum of 24 credit hours) sent directly to the South Holland Business Association Foundation by May 31, 2025.

SIGNATURE & CONSENT

By signing below, I confirm that the information provided is true and accurate to the best of my knowledge.

I agree to provide any further information requested by the SHBA Foundation and authorize the verification of all details included in this application.

I also understand that I am eligible for a maximum of three SHBA

scholarships, strictly for undergraduate education.

Signature

Signature field is empty.

Date:

COMPLETED APPLICATIONS AND TRANSCRIPTS

(INCLUDING FINAL TRANSCRIPT FOR SPRING 2025)

MUST BE SUBMITTED BY

Saturday, May 31, 2025 at 11:59 pm

Submit via email to: servingsouthholland@gmail.com

OR Mail to:

SHBA Foundation

P.O. Box 334 South Holland, Illinois 60473

SOUTH HOLLAND BUSINESS ASSOCIATION FOUNDATION

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