Prairie Trail Scholarship Application

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Some content may be updated based on selection

Prairie Trail Scholarship Application

Personal Information:

Currently I:

Prairie Trail Address:

Street Address:

Title Holder of Property:

My relationship to the title holder:

This Scholarship award can only be given to students who reside in the Prairie Trail Development. Please return to the main scholarship page.

Last Name:

First Name:

Middle Initial:

Date of Birth:

SSN:

Gender:

Ethnicity (select all that apply):

American Indian or Alaska Native
A person having origins in any of the original peoples of North and South America (including Central America) and who maintain tribal affiliation or community attachment.

Asian
A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.

Black or African American
A person having origins in any of the black racial groups of Africa

Hispanic or Latino

Native Hawaiian or Other Pacific Islander
A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

White
A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.

Marital Status:

Number of my dependents that are 18 and under:

I am head of my household:
(major income provider in a home with children)

Total # in my household:

Contact Information:

Current Mailing Address:

City:

State:

Zip Code:

I am an Iowa Resident:

I am a US Citizen:

Iowa County:

Phone Number:

Email Address:

Academic Information - Past and Present

Name of High School

City

State

I am currently attending this school

I graduated from this school

Graduation Mo/Year

I am no longer attending this school

I have a GED

I have attended/currently attend college

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