Scholarship - Application

Scholarship Application Form

APPLICATION DEADLINE: March 31, 2026

Scholarships will be presented at our annual graduation recognition in May. All graduating high school seniors in our programs will be invited to the celebration.

APPLICATION FORM:

Applicant Information:

First name

Last name

Home Phone

Cell Phone

Work Phone

Gender

Address

City

State

Zip Code

Country

Date of Birth

Month

Day

Year

Family Information:

Parent/Guardian

Parent/Guardian Email

Parent/Guardian Phone:

Home Phone

Cell Phone

Parent/Guardian Address the Same as Above?

Yes

Address

City

State

Zip Code

Applicant Education:

Name of the School I am graduating from this year.

Principal

Guidance Counselor

School Address*

City

State

Zip Code

School Phone

Graduation Date

Month

Day

Year

Future Plans:

College Plans:

Career Goals:

Future Plans:

Clubs, Sports, Religious/Political Organizations, etc.

Volunteer Experience:

Honors and Awards

Additional:

Future Plans:

Provide the names of two references capable of discussing information about your abilities and character. Littles are encouraged to list your Big as your first reference.

References Name #1

References Name #2

References Name #1

CHECK BOX: Littles, if the first reference is your Big, please check here.

First Reference Name

How do you know this person?

Second Reference Name

How do you know this person?

Phone

Essays (Please provide a minimum of a two-paragraph response to each essay question. You are welcome to share more if you wish.)

How has having been involved in Big Brothers Big Sisters impacted your decision to further your education?

Describe an experience you have had within the Big Brothers Big Sisters Program that has contributed to your overall personal growth.

Verification Statement: Check One

Approximate Match Starting Date

Month

Day

Year

If no longer a current program participant: Approximate Match Ending Date*

Month

Day

Year

Multi choice

I am currently a Little in the Big Brothers Big Sisters of South-Central PA program.

I am currently a High School Big in the Big Brothers Big Sisters of South-Central PA program.

I have been previously matched in the Big Brothers Big Sisters of South-Central PA program for over a year.

By selecting “submit,” I agree that the information stated in my application is accurate and that the essay answers are my own work