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Scholarship Application Online Form

Use this form to apply for the annual Dr. Diters scholarship.

Please enter a valid email address for the student

List all schools/colleges to which you have been accepted

Enter your highest SAT Critical Reading score

Enter your highest SAT Math score

Enter your highest SAT Writing score

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Statement of Financial Need for One Year: Tuition, room & board, fees, books, supplies, various personal expenses, transportation)

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Statement of Financial Need for One Year: What is the expected Family Contribution amount?

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Statement of Financial Need for One Year: What is the expected amount of your contribution?

Did you file a F.A.F.S.A? (Yes or No)

What is the number of family members in post-secondary education next year?  (At least 1/2 time)

What other scholarships or financial aid from any source have you already been offered?  Please state source and amount (Pell Grant, Awards, Scholarships, Loans, Grants). 

FAILURE TO DISCLOSE ANY OF THE ABOVE MAY RESULT IN LOSS OF AWARD

Please report any unusual family or personal circumstances you feel warrant attention

Write a statement of your plans as they relate to your educational and career objectives and future goals.

Please list all activities that you participated in.

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