Student Scholarship Application

Complete this form to apply for consideration for a sponsored place through the Nexa Graduate Readiness Scholarship Program. Please provide accurate information; submission does not guarantee a scholarship place.

Student Name

First Name *

Last Name *

Email Address *

Phone Number *

City / Location *

Education Status *

Secondary School Graduation Year *

Intended Field of Study *

Why are you applying for this scholarship? *

Financial Need and Circumstances *

Additional Information

Applicant Confirmation *