Project Hearing – Initial Scholarship Application

The application for scholarship must be completed by April 1st of the current academic year to qualify for a fall scholarship.

* Required application fields are denoted with a red asterisk.

Direct questions to Assistance League of Boise Project Hearing voice mail at (208) 780-9916. Your call will be returned as soon as possible. It could take 24 hours to return your call so plan accordingly.

"*" indicates required fields

Name*

First Middle Last

Address

Street Address City State ZIP Code

Are you a resident of Ada County?*

Yes

Home Phone

Cell Phone*

Email*

Date of Birth*

Hearing Impairment (provide verification):

Decibel loss right ear*

Decibel loss left ear*

Applicant's School Information

School attending currently*

Principal/Dean’s name*

School address (currently attending)*

Street Address City State ZIP Code

Cumulative GPA (provide transcript)*

Graduation date*

School planning to attend*

School address (planning to attend)*

Street Address City State ZIP Code

School phone number*

Financial aid advisor*

Annual cost for a year of study (tuition, books, room & board)*

List other scholarship aid received & amounts

Applicant's Financial Resources

Checking $*

Savings $*

Stocks, Bonds $

Home $

Other real estate $

Vehicles $

Boats & RV $

Other $

Applicant's Annual Income

Employer Name

Employer Phone

Position

Number of hours worked per week

Social Security $

Vocational rehabilitation $

Other $

Yearly gross income*

Describe any other impairment in addition to hearing impairment

Family Information

Father's (Guardian) Name

First Last

Father's (Guardian) Age

Father's (Guardian) Employer

Father's (Guardian) Position

Mother's (Guardian) Name

First Last

Mother's (Guardian) Age

Mother's (Guardian) Employer

Mother's (Guardian) Position

Parent’s (Guardian) yearly gross income*

Parent’s (Guardian) financial resources

Checking $*

Savings $*

Stocks, Bonds $

Home $

Other Real Estate $

Vehicles $

Boats & RV $

Other $

Number of dependents in family & ages*

Number of other members of family attending college or vocational school next year*

Parents or siblings with disabilities?*

Yes

Describe

Other Information

Describe your education and career goals*

Personal statement: Tell us why you think you are deserving of this Scholarship.*

Work experience

Click on the plus icon at the end of the row to add another row.

Employer

Position

Date

Professional memberships and activities: (past 2 years)

Organization and offices held

Community service and/or extracurricular activities: (past 2 years)

Honors/Scholarships: (past 2 years)

If you are chosen for a scholarship, may Assistance League of Boise publish your name and photograph?*

Yes

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Online Scholarship – Initial Application

Project Hearing – Initial Scholarship Application

The application for scholarship must be completed by April 1st of the current academic year to qualify for a fall scholarship.

Hearing Impairment (provide verification):

Applicant's School Information

Applicant's Financial Resources

Applicant's Annual Income

Family Information

Parent’s (Guardian) financial resources

Other Information