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Young Professionals Inc |
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Please note: We
are in dire need of donations, there have been very
little contributions and we are asking you to give seeking the face of Allah. We have received many inquires
from those who need help from Allah, help from us and help from you. We need $5000 to reach our goal! Please see the "Contact Us" page to donate. No donation is too small, as we give seeking the Pleasure
of Allah, Al Wasi. September 2007
Application for Acceptance Please print out the application
and mail it in, fill it out completely using black or blue pen only. If more space is needed please use additional paper.
Circle the appropriate answers when applicable. For grade: _____ in the academic year of ___/____/___ Applicant Full name ____________________________________________● Male ● Female Permanent address ___________________________________________________________ Telephone number ____________________________ Date
of birth _____________________ Race or national origin
(optional) ___________________________ U.S. Citizen: Y or N Place of birth ___________________________________
School Applying to: ______________________________________________ Present
grade_________ Contact Person __________________________________ Telephone number ____________________________ Completed grades ______________ - _____________ School Address ______________________________________________________________ Name of Principal or school's
Headmaster __________________________________________________________________________ Previous schools attended
(include phone numbers and grades completed) __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ Please list 2 teacher
and 1 additional adult as a personal reference. (No relatives please) 1. Teacher__________________________________________________________________ 2. Teacher __________________________________________________________________ 3. Other Reference_____________________________________________________________ Parent(s) or Legal
Guardian Student lives with:
● Father ● Mother ● Stepfather ● Stepmother ●Other (please specify) Circle any that apply:
● Father is deceased ● Mother is deceased ● Parents are separated ● Parents are divorced Parents or legal guardians
full name Full Name _________________________________________________________________ Home address _______________________________________________________________ Phone __________________________________ Work Phone_________________________ Employer ________________________________Occupation
Title______________________ Employer address ____________________________________________________________ Mother’s Name ______________________________________________________________ Home address _______________________________________________________________ Phone ______________________________ Work
Phone_____________________________ Employer __________________________________Occupation
Title____________________ Employer address ____________________________________________________________ Names, ages and present
schools of brothers and sisters: Name
age
school
relationship __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ How did you hear about
Young Professionals Inc Scholarship Program? __________________________________________________________________________ __________________________________________________________________________ Signature of parent
or legal guardian ________________________________ Date _____________ Financial Requirements Due to the number of submitted applications,
each Parents/Guardian must provide proof income. As some families may only qualify for a partial scholarship, other
families may qualify for a full 1-year scholarship. At least ONE OF THE FOLLOWING 3 items are required for proof
income. However single sisters with children, who are not working, may receive special consideration regarding
their financial ability, (please contact us for more information). We recommend cutting out the social security
# from your submitted income information. SS# is NOT REQUIRED; cutting out the SS# on your tax or pay stubs will not
affect your application. ESSAYS Essays are
required for children ten years old and older. Select 2 essay topics to write about, each essay should be a minimum
of 1 page; include the topic question at the top of each page. Please mail in each essay along with your application
and financial information. Q1. What would you
like to be when you grow up? What goals would you have liked to have had accomplished in five years? What goals would you have liked to have had accomplished in five years?
(Please be descriptive) Q2. Describe your contribution to your community (school, family, Mosque, volunteer work etc.) and
what you will contribute back to your community after completing your education. Q3. Describe a challenge that you faced and how you managed to overcome it.
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