Continuing Education
Durham ConnectFund Grant Application
Eligibility: In order to receive this grant, applicants must have graduated from a Durham Public high school, or must be a
current Durham county resident.
Last Name: First Name: MI:
Address: City: State: ZIP:
High School Diploma/GED
(name of school): Year of Graduation:
Email address: Home: Cell:
Date of Birth: Gender: Male Female
Employment Status: Full time Part time Unemployed Underemployed (individuals earning 200% below the federal poverty level)
Ethnicity
AN American/Alaskan Native WH White
NHS Non-Hispanic/Non-Latino
AS Asian HP Hawaiian/Pacific Islander
BL Black/African-American HIS Hispanic/Latino
Program of Study:
Financial Information: Please list all financial assistance you ar
e receiving or expect to receive to include, but not limited to:
grants, loans, scholarships, tuition waivers, Veteran’s benefits, or other. (Applicants are responsible for determining if the
award of this grant will disqualify them from other sources of financial assistance.)
Fr
om Date Amount
1.
2.
Personal Essay: Please answer the following two questions in your essay: What are your education/career
-related goals?
Describe why you should be selected to receive this grant? (Maximum 300 words. Attach typed or neatly printed document
in English if additional space is needed.)
Signature: Date:
11/18
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signature
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