Scholarship Application 2022 - GA Haitian-American Chamber of Commerce, Inc.

1. Name*
First Last
2. Mailing Address*
Street Address City State / Province / Region ZIP / Postal Code
3. Cell Phone Number*
Email Address*
4. Date of Birth*
Date Format: MM slash DD slash YYYY
Gender*
- Male
- Female
- Other
5. Cumulative Grade Point Average (GPA):*
(On a 4.0 scale)
Attach proof of GPA. Your most recent school transcript is required.*
6. Are you of Haitian Heritage*
- YES
- NO
7. Name and location of High School attending*
8(A):List any academic honors, awards and membership activities while in high school*
8(B): List your hobbies, interests, extracurricular and school-related volunteer activities*
8(C): List your non-school sponsored volunteer activities in the community*
8(D): Upload their resume and/or activities sheet*
8(E): Upload your picture ID*
Accepted file types: jpg, png, .
9(A). If you have decided on what college/university you will attend, please list the name:*
9(B). Include a pdf copy of acceptance Letter*
10(A). Career Goal:*
10(B). Relevant Internship or Work Experience:*
11. Are you or your parent or legal guardian born in Haiti or are of Haitian descent?*
- YES
- NO
If your answer is ‘yes’ please answer blocks A, B, C below.
12(A): His/her full name:*
Full Name
12(B): What city in Haiti are you or your parents from?*
12(C): What Haitian community or organization are you or your parents a part of?*
13. Name & address of parent(s) or legal guardian(s):*
(Include address if different than the one listed in Question 2.)

Street Address City State / Province / Region ZIP / Postal Code
13(A). Cell phone of parents or legal guardians*
13(B). Email address of parents or legal guardians*
14. Personal Essay Questions
14(A). How do you identify as someone of Haitian heritage?*
14(B). Choose one of the three question & answer them:*
*
Phone
This field is for validation purposes and should be left unchanged.

14. Personal Essay Questions