Application Form Personal Information About the ApplicantName* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Phone*Is the applicant a minor?* Yes No State in Which You Reside* North Carolina Pennsylvania Virginia Academic InformationName of School You Attend*Type of School* College High School Middle School Elementary/Intermediate School Grade*Classification*Grade Point Average (if applicable)*School Rank:*RankTotal Number of StudentsSAT or ACT Scores*(High school juniors and seniors only)Activities and InterestsPlease list and briefly describe your school activities.*Organization InvolvedPosition HeldDates of InvolvementBrief Description of Responsibilities Please list and briefly describe your volunteer activities.*Organization InvolvedPosition HeldDates of InvolvementBrief Description of Responsibilities Please list honors and academic awards you have received.*Award / HonorOrganizationDate Please list and briefly describe any work experience (if applicable).*PositionEmployerDates of EmploymentBrief Description of Work Responsibilities Thoughts of the ApplicantWhy do you want to be a Carter scholar?*How will financial support from Carter Scholars Inc. help you to achieve your academic goals?*Is there any other information that we should know about you? This is your opportunity to include information that is not contained in other areas of the application. Please be specific.*About the Applicant’s Parents or GuardiansFirst and Last Names of Parent / Guardian* First Last Address of Parent / Guardian* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email Address of Parent / Guardian* Phone Number of Parent / Guardian*Financial NeedPlease describe your financial need.*Carter Scholars Inc. may provide financial support for the following items. Your total should not exceed $500.Field trips* Gas for vehicles (college students only)* Housing* School supplies* School-related technology* Textbooks* Tuition* Uniform* Other:* Please describe below.Description of other financial need (if applicable)*Total $0.00 Total should not exceed $500Additional InformationHave you received funding from Carter Scholars Inc. in the past?* Yes No If yes, please provide the date (month, day and year) of your last application.* Month Day Year If approved for funding, you will receive the money via the Cash app. Please provide your Cash app handle.*Please upload your unofficial academic transcripts (high school students and college students).* Drop files here or Select files Accepted file types: pdf, jpg, jpeg, Max. file size: 1 MB, Max. files: 5. Please upload your photograph (only if you receive funding and only if you are comfortable submitting the photograph).Accepted file types: jpg, jpeg, png, webp, Max. file size: 1 MB.Statement of AccuracyWe hereby affirm that all the information provided above is true and correct to the best of our knowledge.Printed Name of Applicant*Signature of Applicant*Date* MM slash DD slash YYYY Printed Name of Parent / Guardian*Signature of Parent / Guardian*Date* MM slash DD slash YYYY