Geneseo Local Scholarship Application

Click on the link below for instructions and information on all Local Scholarships


Geneseo Local Scholarships Instructions and Descriptions 2018



Local Scholarship


Name of Scholarship



Applicant's Information



Name of Applicant

Age of Applicant

Address of Applicant


Class Rank

Cumulative GPA



Phone Number



Email Address

Number of Siblings


School You Currently Attend

Parent/Guardian Information



Father's/Guardian's Name


Father's/Guardian's Employer



Mother's/Guardian's Name



Mother's/Guardian's Employer



Student Activities


Extra Curricular Activities - please list and tell why you decided to participate in these activities.



Community Activities:



Church Activities:

School Information


Name of School you plan to attend





Estimated annual total cost $


Annual parent contribution $


Your annual contribution $



Do you plan on working during the college school year?



Are you willing to borrow to complete your education?



Briefly state why you want to attend college



Briefly list honors/awards you have received while in high school


Brief work history


IF REQUIRED BY SCHOLARSHIP SPONSOR: With their permission, please list names and phone numbers of references as requested by scholarship sponsor.


References Please provide Name, Phone Number and Occupation











IF REQUIRED BY SCHOLARSHIP SPONSOR: Please click to expand the Supplemental Information Section below and/or the Financial Disclosure field.

Essay Field / Information Box

You may type in or copy/paste information in the field below.






Financial Disclosure Form


The following scholarships require additional Financial information.


Geneseo Foundation Scholarships
Ralph and Dorothy Graham Scholarship
Lyle and Helen Henry Scholarships
Livengood-Resser Scholarship


If you are not applying for a scholarship listed above please do not fill out this portion of the application.


I live with


Father's Gross Income


Mother's Gross Income


Applicant's Place of Employment


Average Gross Income

College Financial Aid you have Received:


Pell Grant


Illinois Guaranteed Loan Program


College Gift Aid


Supplemental Education Opportunity Grant


Illinois State Scholarship Commission


Court Ordered Support for Higher Education




Total Funds Currently Available for Education (All Sources)


In 100 words or less state your educational goals and any financial history, which may factor into your postsecondary decisions.






Upload Additional Information


Here you can upload a PDF or Word file which contains letters of recommendation and or student transcripts, if required for the scholarship you are applying.


Sign and Submit


I agree that I am the person whose name is listed below.


Applicants Name




Copyright 2018