2016 Hord Scholarship Application

Applicants for the Hord Scholarship must be of African/African American descent.
Mandatory fields have red asterisk(*)
Last Name (Student)* First Name (Student)*
Last Name (Parent/Guardian)* First Name (Parent/Guardian)* Email (Parent/Guardian)*
Mailing Address
City*   State* Zip Code*
Phone (Daytime)* Phone (Mobile)*
Email* Personal Email*
Student High School* Graduation Year*
College Information
Have you ever received a Hord Foundation Scholarship?* Yes No
Check the prior years you have received a Hord Scholarship.*  2015 2014 2013 Other
If you were a first time recipient in 2015, have you completed 2 hrs of community service?* Yes No
Desired Occupation/Career*  
Intended College Track* 4 year 2 year Vocational Non-Traditional
Any applicant who has either been out of school for 4 or more years and plans to attend non accredited or accredited institution proof of acceptance or current student enrollment from the above school is required. See Eligibility.
Name and address of college(s) or universities currently attending or applied. List your top two choices.
First Choice College Name* Status* Attending Accepted Pending
City* State* Zip Code
2nd Choice College Name Status Attending Accepted Pending
City State Zip Code
In the fall of 2016, I will be attending college as a *
Freshman Sophomore Junior Senior
College Major* Are you on a honors academic track in school?*   Career Goal/Profession* 
Student GPA* 
Student ACT 
Student SAT 
Are you a 1st generation college student?* 
Number of other scholarships for which you have applied?* 
Current community activities: (church, clubs, volunteer, etc.)
Current School/extracurricular activites: (class office, band, school newspaper, sports, club, etc)
Awards and special recognition 
Financial Information
Family Income (2015)*

less than 40000
40000 to 60000
60000 to 80000
80000 to 100000
100000 to 150000
150000 to 200000
greater than 200000

Financial Certification*  I certify that the fianancial information contained above is accurate to the best of my knowledge.
In the space provided below please type a 350 word essay for the question. There will be strict adherence to this word count. Exceeding the limit could result in the reduction of your application scores.

The lessons we take from failure can be fundamental to later success. Recount an incident or time when you experienced failure. How did it affect you, and what did you learn from the experience? *


The Hord Foundation has my permission to use this essay or part of the essay for public awareness and fundraising.* Yes No
Are you of African American descent?* Yes No
Mail most recent transcript to: Hord Foundation P O Box 4671 Danbury Connecticut 06813
Application Certification* I certify that the information contained in this application is accurate to the best of my knowledge.
Please print a copy of this application for your records!