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Transforming lives in Martinsville and Henry County VA

The application must be completed in full. Full is defined as completing all application questions including all document uploads (even the official transcript).

You will not be able to come back and edit this form. Please do not fill it out until you have all of the requested information available.

Fields marked with an * are required.

APPLICATION INFORMATION
EDUCATION
EMPLOYMENT HISTORY
COMMUNITY SERVICE
PERSONAL STATEMENTS
  • Complete each in two to three paragraphs, not to exceed 250 words.

Other (Optional)
Document Upload
ATTESTATION AND SIGNATURE
  • I certify that the information provided in my application is complete and accurate to the best of my knowledge and any significant false statements on this application will disqualify me from receiving a scholarship.

  • I understand that my application is not considered complete without an official college transcript, two letters of reference from individuals unrelated to me, a signed community service verification form and a personal photo.

  • I understand that I must be admitted, at the time of this application and disbursement of any funds, in a New College Institute (NCI) affiliated program pursuing a bachelor’s degree, graduate degree, endorsement graduate certificate, or post-graduate degree to receive funds.

  • I understand that I must adhere to all deadlines for my application to be considered and for funds to be released.

  • I acknowledge that any funds received must be used for enrollment in NCI programs and will be paid directly to the partner institution.

  • I understand that the disbursement of scholarship funds is contingent upon me writing a professional appearing thank you note to the scholarship donor(s).

  • I give permission to use my photograph and any general non-financial information included in this application for publicity purposes.

  • I give permission to the colleges or universities I have attended to release any information necessary to review my application.

  • I understand that MHC Academic Foundation will securely maintain my contact information for future correspondence.