Application - Gary Pinkel

Digital Application

No postage required! Complete the fields below to apply for a 2023 GP M.A.D.E. Foundation Scholarship.

Name*

First Middle Last Preferred Name/Nickname

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Date of Birth*

Best Phone Number to Reach You*

Is this a mobile phone?*

Yes
No

May we text you?*

Yes
No

Email is the primary form of communication for GP M.A.D.E. Foundation Scholarship applications, but texting may be used to request additional documents or to update you about your scholarship status.

Alternate Phone Number

Email that is Checked Regularly*

High School Info and College Goals

High School Name*

High School Graduation Year*

Please upload your high school transcripts complete with cumulative GPA*

Max. file size: 256 MB.

What Missouri college/vocational trade school do you plan to attend?*

What semester do you plan to begin attending this school?*

Indicate your classification for the term you are requesting funding (i.e. Freshman)*

What academic degree/major will you be pursuing?*

Anticipated college/trade school graduation date (Month/Year)*

Personal Info

Which categories describe you? Select all that apply.

White/Caucasian
Black/African American
Native American
Hispanic
Other -- please specify

Specify other race or ethnicity here:

Are you a U.S. citizen?*

Yes
No

Parent(s)/Guardian Info

Parent/Guardian 1 Name*

First Last

Parent/Guardian 1 Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Parent/Guardian 1 Cell Phone*

Parent/Guardian 2 Name*

First Last

Parent/Guardian 2 Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Parent/Guardian 2 Cell Phone*

Eligibility Info & Application Materials

Your Eligibility Statement*

To be eligible for a GP M.A.D.E. Foundation scholarship, an individual must: A) Show financial need B) Possess the motivation to succeed, and C) Be of good character. Please describe below how you meet each of the above three criteria.

Personal Profile and Goals*

Please upload a personal profile introducing yourself, explaining your goals, and describing why you feel you should receive a GP M.A.D.E. Foundation Scholarship.

Max. file size: 256 MB.

Recommendations

Enter the names and email addresses of two people who will recommend you. You could include an instructor, counselor, advisor, supervisor or other similarly qualified individual who will submit a recommendation on your behalf. NOTE: As the applicant, it is your responsibility to inform that person to watch for an email sent on your behalf that will explain how to complete this process.

FIRST RECOMMENDATION*

First Last

FIRST RECOMMENDATION EMAIL*

SECOND RECOMMENDATION*

First Last

SECOND RECOMMENDATION EMAIL*

Acknowledgement

Photo Release and Consent Form*

I Consent

I hereby consent to the use of photographic image and/or name by the GP M.A.D.E. Foundation Inc. in any printed form or on any website or social media application of the Foundation. I further that the Foundation is free to select, crop or otherwise alter any photographs or videos without prior consultation with me. I understand that I am donating and assigning all copyrights or other intellectual property rights to such photographic images or videos, and that there will be no payment or compensation for the photographs, videos, or their use.

In giving my consent, I agree that I shall not bring or file any complaints, claims or causes of action of any kind against and release the GP M.A.D.E. Foundation Inc. for any matter in connection with the use of my photographs, videos and name.

Photo Release: Parent Signature*

Name Date

Photo Release: Student Signature*

Name Date

Applicant Signature

By entering my full name below, I authorize the GP M.A.D.E. Foundation and their agents to examine, verify and discuss my academic and other information that apply to the consideration on this application. I certify that all answers are accurate and truthful to the best of my knowledge, and that all information in the application and essays are my own work. I understand that the decisions made regarding my participation in this program are made by GP M.A.D.E. Foundation, in reliance upon the truth and correctness of my statements.

Students, enter your full name to sign:*

Scholarship Application

Digital Application

High School Info and College Goals

Personal Info

Parent(s)/Guardian Info

Eligibility Info & Application Materials

Recommendations

Acknowledgement

Applicant Signature

Join Gary’s Journey