Bloom Scholarship Application

Personal Information

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Date of Birth

YYYY

Education Status

Have you been enrolled in college/university for the past year?

Please expand upon your 2024 education status whether you have been enrolled full-time, part-time, or not at all.

If you HAVE been enrolled, tell us what you are studying and how it is impacting you. If you HAVE NOT been enrolled, please tell us why, what your focus has been in the interim, and the date of your last enrollment.

Enrollment Details

Cumulative Grade Point Average (GPA)

(On a 4.0 Scale)

Please list the name of the college/university you are most likely to attend/are attending

Have you applied to this college/university?

Have you already been accepted into this college/university?

What date do you anticipate being enrolled at this college/university?

YYYY

Do you plan on attending full-time or part-time?

Please choose your answer from the dropdown menu.

Do you plan to live on campus, at home, or in independent housing?

Please choose your answer from the dropdown menu.

What program or course of study are you pursuing and why?

Name of the certificate/degree you will earn (for example, Bachelor's, Master's, etc.)

What is the length of the program in years

Anticipated date of completion of the certificate or degree

YYYY

Financial Information

What is the cost of tuition and fees for one year at the college/university you are attending?

*Please reference your school’s website for an estimation if you don’t know the exact cost.

What is the cost of the books and supplies necessary for your study during the academic year?

Have you applied for and/or received any other scholarships or financial awards for the upcoming school year? If so, please list.

Please list who you have received awards from and dollar amounts of what you have received.

Certification

Please sign and acknowledge the following statement.

I acknowledge decisions of Taylor’s Closet are final. In submitting this application, I certify I meet the eligibility requirements of the program as described in the guidelines and the information provided is complete and accurate to the best of my knowledge. I understand that any misrepresentation or omission of information may be cause for disqualification, and that falsification of information may result in termination of any award granted. I understand that all letters of recommendation are confidential, and the content will not be shared with me.

First Name

Last Name

Date

YYYY