2019 Scholarship Application

The Leaders of Southeast Iowa Foundation Scholarship was established for graduating seniors from any Lee County, Hancock County, or Clark County High School. The student must be as a resident of Lee County, Hancock County or Clark County. Students must be in the Top 25% of their graduating class at their high school.

A Leaders of Southeast Iowa Foundation recipient(s) must attend or be enrolled in an college or university upon high school graduation. The scholarship award is $1,000.00.

Deadline for scholarship applications is April 1, 2019. The Leaders of Southeast Iowa Foundation Scholarship Recipient will be selected and announced by May 1, 2019.

Please complete the Scholarship Application below.

Name *
Name
Date of Birth *
Date of Birth
Phone *
Phone
Address *
Address
Please check the high school you attended
Parent of Guardian *
Parent of Guardian
Parent of Guardian Phone # *
Parent of Guardian Phone #
Counselor's Name *
Counselor's Name
Address of Planned College/University *
Address of Planned College/University
Digital Signature (I have read the Authorization Statement) *
Digital Signature (I have read the Authorization Statement)
 

By submitting this application, I certify that the information contained therein is true and complete to the best of my knowledge and understand that false information or omission of data may result in denial of my application. I understand that the information submitted will be considered confidential in review by the Leaders of Southeast Iowa Foundation. If chosen for the Leaders of Southeast Iowa Foundation Scholarship award, I agree to complete the Scholarship Recipient’s Agreement Form and return it to the Leaders of Southeast Iowa Foundation. I understand that if I do not return a completed agreement, my scholarship funds will be awarded to the selected alternate. I also agree that my name can be used in announcements made by the Leaders of Southeast Iowa Foundation regarding the particular scholarship(s) for any scholarship that I may be awarded.