Rockin’ Scholar Scholarship Application

Applications for the 2024-2025 academic school year will be open April 28, 2024 through August 16, 2024. Applicants will be notified of scholarship status in early September.

Applicants must be a person with a Down syndrome diagnosis who are enrolled in a certificate or undergraduate course of study at an accredited two-year or four-year college or university for the upcoming academic year or will be attending a work program and/or an employment/vocational training program. Before submitting the application, please click here to view eligibility requirements.

All applicants must complete the below form and submit two letters of recommendation. If accommodations are required to complete the application, please email info@rockthe21.org. Click here to access the recommendation form.

Name

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Birthday

YYYY

Parent and/or Legal Guardian

First Name

Last Name

Phone

(###)

###

####

APPLICANT EDUCATIONAL BACKGROUND

High School Name

City / State

Graduation Date

YYYY

Please list any community service, clubs, sports, awards and/or other extracurricular activities you participated in during high school, if applicable.

APPLICANT RESPONSES

Applicants should answer the questions below with a brief response.

In a few sentences, describe what your favorite course in high school was and why?

If you could select one word to describe yourself, what word would you select? Please explain why.

What do you hope to learn in college and/or in a job skills training program?

Briefly describe why you should be selected to receive the “Rockin’ Scholarship” .

Please use the space below to provide any other information about yourself.

PROGRAM DETAILS (where scholarship will be applied)

Please list the name of the program or educational institution you are enrolled in or will be applying to.

APPLICANT ACKNOWLEDGEMENT

I confirm that I have a medical diagnosis of Trisomy 21 also referred to as Down syndrome.

I agree to provide a photo and further allow Rock the 21, Inc to use that or any other photo, video, or film likeness to be used for any legitimate purpose by Rock the 21, Inc., including, but not limited to, in any publication or broadcast of Rock the 21, Inc. intended for research, educational, promotional, fund-raising or other related use. I agree to hold harmless and not to sue Rock the 21, Inc. or any of its agents, employees or volunteers for any use of my photo, video, or film likeness for any legitimate use thereof.

Please ensure that you read and understand the eligibility guidelines before affirming this statement. By submitting this application, I hereby attest that all the responses provided in this application form are my own and that the provided information is true and accurate. I acknowledge and agree to abide by all eligibility guidelines outlined for this application. I am aware that providing false information can result in the forfeiture of the scholarship.