Email *

Student's First Name *

Student's Last Name *

Student's mailing address (Street and City) *

Student's mailing Zip Code *

Student's Cell Phone # *

High School Name and City Currently Attending

Total Weighted GPA (from 9th thru 12th grade) ** (A current transcript showing a GPA of 2.5 or higher will also need to be submitted. See below for details.) **

Total Community Service Hours (from 9th thru 12th Grades) ** (A list providing details will also need to be submitted. See below for details.) If none, write “none”

Total Work/Job Hours (from 9th thru 12th Grades) ** (A list providing details will also need to be submitted. See below for details.) *If none, write “none”

Total Extracurricular Activities Hours (from 9th thru 12th Grades) ** (A list providing details will also need to be submitted. See below for details.) *If none, write “none”

Career Goal *

University/State/Community College you hope to attend *

Please list all other Scholarships, Grants, etc. you have been awarded (list Who From and What Amount). If none, write "None".

Parent/Guardian's First & Last Name

Parent/Guardian's Cell Phone # *

DHH Teacher, Case Manager and/or School Counselor’s First & Last Name *

DHH Teacher, Case Manager and/or School Counselor’s Email *

DHH Teacher, Case Manager and/or School Counselor’s Phone *

YOUR APPLICATION WILL BE COMPLETE ONCE YOU submit THIS FORM and THESE REQUIRED DOCUMENTS (Click this link to access documents) YOUR APPLICATION WILL BE COMPLETE ONCE YOU submit THIS FORM and THESE REQUIRED DOCUMENTS (Click this link to access documents) Typewritten essay about you (250-350 maximum words) Please send via Email Lists of your Community Service, Work and Extracurricular Activities A current transcript showing a GPA of 2.5 or higher on a 4.0 scale, from 9th grade through first semester of 12th grade. Audiogram unaided

THIS FORM AND THE ABOVE DOCUMENTS MUST BE RECEIVED BY MARCH 23rd 2025 THIS FORM AND THE ABOVE DOCUMENTS MUST BE RECEIVED BY MARCH 23rd 2025 I am submitting these documents by email to: info@ardisfoundation.org (write "YLWC Scholarship" in Subject line) I am mailing these documents to: Ardis Foundation, Attn: Scholarship P.O. Box 387 Yorba Linda, CA 92885