The House of Blahnik Scholarship Application

In addition to completing the form application below you will need to send the following:

Official transcripts from high school or college
Letter of acceptance from institution
Three (3) Letters of Recommendation

Name
First Name(required)
Middle Initial(required)
Last Name(required)
Address
Address(required)
City(required)
State(required)
Zipcode(required)
Date of Birth (mm/dd/yyyy):(required)
Age:
Contact Number (Day):
HOME WORK CELL
Contact Number (Evening):
HOME WORK CELL
Contact Number(required)
Email Address(valid email required)
Race (Optional):(required)
Sexual Orientation (Optional):(required)
HIGH SCHOOL/COLLEGE EDUCATION *List schools from most recent to least recent
Name/Location of Institution
1
2(required)
3(required)
Years of Attendance
1(required)
2(required)
3(required)
Course of Study
1(required)
2(required)
3(required)
Diploma/Degree
1(required)
2(required)
3(required)
GPA
1(required)
2(required)
3(required)
Honors, Fellowships, Awards, Extracurricular Activities, Publications, Exhibitions, Performances, ETC.
(List your most significant achievements, which concern gay-related/sponsored organizations. Be sure to include any groups or houses that you belonged to within the ballroom and for how long.)(required)
Please list the institution(s) you will attend in Fall 2008
Institution
1(required)
2(required)
3(required)
Location
1(required)
2(required)
3(required)
Program/Degree
1(required)
2(required)
3(required)
Have you been accepted to this institution/program?
YES NO
When will you be notified?(required)
COMMUNITY BUILDING
What does community mean to you? Based on your definition of community how do you see yourself within your community?(required)
What kind of issues or social problems do you see facing your community? How have you worked to improve these problems or issues?(required)
If selected for the scholarship how will you use this is as an opportunity to impact change within the community?(required)
CONTRIBUTIONS TO THE BALLROOM
What people (you don't have to give names) contributions - negative or positive - have influenced your development within the ballroom community?(required)
The ballroom is a microcosm of the larger community. How have societal events impacted the ballroom community in which you exist?(required)

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