Miss America Foundation State/National Teen Scholarship Request Form

Completion of the one-time online Registration Form is required prior to submitting your scholarship request.

Please note each scholarship requires a separate request form.

Candidate Information

First Name

Last Name

Phone

Birthdate

Last 4 SSN

Maiden Name

Ethnicity

College Name

College Major

Address

Address Line 1

Address Line 2

City

State

Zip Code

Scholarship

Scholarship Type

Competition Year

Award Type

Make Check Payable To:

School address for tuition payment. Lending Institution address for loan payments.

Student ID for tuition payment. Account number for loan payment.

Date of High School graduation and any additional comments.

Request

Total Request Amount **Please do not use commas or periods

Expense Type

Tuition/Room & BoardStudent LoansEducational Expenses

These documents must be uploaded in order to submit your application

Promissory Note (if student has a loan, then promissory note is required)

Transcript
Unofficial transcripts are fine

Current Invoice
Date must be within 30 days of application

State ED Letter
Letter from State ED stating you have used all your local and state award money

Please contact Lani LiCalzi at lanilicalzi@themissamericafoundation.org with any questions.