Scholarship Submission Form
P
LEASE NOTE: This scholarship is available to currently enrolled college students and/or high school students in their
senior year who are pursuing a career in marketing, business, entrepreneurship or technology. For further rules and
restrictions please visit our scholarship page at www.triadexservices.com
.
*
Applicant’s Full Name
*H
ome Phone *Email
*S
treet Address Line 1
Street Address line 2
*
City *State *Postal / Zip Code *Country
*
Date of Birth *Are you a U.S. Citizen? Yes No
Parent/Guardian Information (If Applicable)
E
mail
State Postal / Zip Code Country
PARENT/GUARDIAN 1
Parent/Guardian’s Full Name
Home Phone
Street Address Line 1
Street Address line 2
City
Email
Sta
te Postal / Zip Code Country
PARENT/GUARDIAN 2
Parent/Guardian’s Full Name
Home Phone
Street Address Line 1 Street
Address line 2
City
Questionnaire
Please answer all questions as completely as possible, use additional paper as needed
Name all schools you have attended in the last five years. List the school you are presently attending first.
How many years do you plan to attend college, and what course of study would you like to pursue or are you pursuing?
What business or educational career will you likely pursue after finishing college?
If applicable, what college(s) would you most like to attend? Please explain your reason.
If applicable, what colleges have you applied to for admission? Please indicate acceptance status.
List scholarships, grants or loans for which you have applied, and check the ones you plan to use. Indicate funding
amount you will receive.
Academ
ic, athletic, service, and extra activities. Use additional pages or attach resume if necessary.
List participation in athletic activities.
List participation in community service and any leadership positions.
List jobs you have held in the last 3 years. (Include Dates, Position, and Compensation)
*Signature
*Attach a certified transcript of the student’s current high school and/or college records.
*Please attach or append any additional information that would aid in our selection.
*Email Application to info2@triadexservices.com Subject: Scholarship Application