Scholarship Application Family Information Sample

* required information
Parent Information 
If any item does not apply, write "N/A"  
First Name:*
Last Name:*
Parents' Marital Status:*
Marital Status if other:
Year:*
Who do you reside with:* Both Parents
Mother
Father
Legal Guardian
 

Please complete the following information about your biological or adopted parents.

 
Mother's Information
First Name:*
Last Name:*
Maiden Name:
Birth Date:(mm/dd/yyyy)
Living:* Yes No
Deceased Date:(mm/dd/yyyy)
Birth Place (City, State, Country):*
Citizenship:* U.S.Citizen Other
Citizenship if other:*
Daytime Phone:*
Cell Phone:
Email:
Current Employer:*
Job Title:
Length of Time at Position:*
Annual Gross Income:*$
Other Sources of Income:*
Other Income Annual Amount:$
College(s) Attended (Include dates & degrees earned):*
Additional Notes:
Remarried: (if applicable)
Remarried Year:
 
Father's Information
First Name:*
Last Name:*
Birth Date:(mm/dd/yyyy)
Living:* Yes No
Deceased Date:(mm/dd/yyyy)
Birth Place (City, State, Country):*
Citizenship:* U.S.Citizen Other
Citizenship if other:*
Daytime Phone:*
Cell Phone:
Email:
Current Employer:*
Job Title:
Length of Time at Position:*
Annual Gross Income:*$
Other Sources of Income:*
Other Income Annual Amount:$
College(s) Attended (Include dates & degrees earned):*
Additional Notes:
Remarried: (if applicable)
Remarried Year:
 
Address and phone number of non-custodial parent: (if applicable)
 
 

If applicable, please complete the following information about your Stepparent or Legal Guardian with whom you reside.

 
Stepparent or Legal Guardian Information
Relationship:
Guardian's Relationship to Applicant:
First Name:
Last Name:
Birth Date:(mm/dd/yyyy)
Birth Place:
Citizenship: U.S.Citizen Other
Citizenship if other:
Daytime Phone:
Cell Phone:
Email:
Current Employer:
Job Title:
Length of Time at Position:
Annual Gross Income:$
Other Sources of Income:
Other Income Annual Amount:$
College(s) Attended (Include dates & degrees earned):
Additional Notes:
 
 

Please complete the following information about your Siblings. Leave blank if applicant is an only child.

 
Sibling Information
Sibling 1 - Name:
Birth Date:(mm/dd/yyyy)
Relationship:
Gender: Male Female
Year in School (if applicable):
Occupation (if over 18 years old):
Has applied for an Evans Scholarship: Yes No
Was awarded an Evans Scholarship: Yes No
 
Sibling 2 - Name:
Birth Date:(mm/dd/yyyy)
Relationship:
Gender: Male Female
Year in School (if applicable):
Occupation (if over 18 years old):
Has applied for an Evans Scholarship: Yes No
Was awarded an Evans Scholarship: Yes No
 
Sibling 3 - Name:
Birth Date:(mm/dd/yyyy)
Relationship:
Gender: Male Female
Year in School (if applicable):
Occupation (if over 18 years old):
Has applied for an Evans Scholarship: Yes No
Was awarded an Evans Scholarship: Yes No
 
Sibling 4 - Name:
Birth Date:(mm/dd/yyyy)
Relationship:
Gender: Male Female
Year in School (if applicable):
Occupation (if over 18 years old):
Has applied for an Evans Scholarship: Yes No
Was awarded an Evans Scholarship: Yes No
 
Sibling 5 - Name:
Birth Date:(mm/dd/yyyy)
Relationship:
Gender: Male Female
Year in School (if applicable):
Occupation (if over 18 years old):
Has applied for an Evans Scholarship: Yes No
Was awarded an Evans Scholarship: Yes No
If more than 5 siblings, please list them here (include same information as above):