Scholarship Application

General Information

Scholarship Applicants

Career Objective

Loan Repayment Applicants

Education

Other

List only activities within the past two years.
Include the organization's name, your position, and dates active. List only activities within the past three years.

Certification:

I certify that I have provided complete and accurate responses to the items on this application. I further certify all documents submitted to support this application are authentic and unaltered records that pertain to me. I certify that I will use scholarship funds for educationally related expenses. If approved for the loan repayment program, I agree to notify QueensCare and / or its designee within 10 days if my current employment is terminated or my status changes from full time. My signature certifies the accuracy and completeness of the information provided. I understand that any misrepresentation may be cause for denial or cancellation of awards offered or granted. I also understand that all scholarships or loans given to me must be claimed within one year of being awarded.

Along with the above-mentioned documents, your institution must send Official Transcripts electronically to info@queenscare.org or by mail to: QueensCare Scholarships Fund, 950 S Grand Ave. Los Angeles, CA 90015. All transcripts must be postmarked by May 1st of the year you are applying.