Welcome

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Graduates of Rockland District High School

Scholarship Application

Name & Address
1
School
2
Leadership
3

Name & Address

All fields marked with are required.

First Name

Last Name

Date of Birth

Email Address

Phone Number

Mobile Number

Street Address

City

Province

Postal Code

Social Media Presence

Provide social media profile URL

Facebook

Instagram

Twitter

School

All fields marked with are required.

Graduated From

Year of Graduation

Grade Percentage

Postsecondary Institution

Accepted?

YesNo

Semester Start Date

Leadership

All fields marked with are required.

Tell me about a time when you demonstrated leadership skills.

Tell me about a time that you took the lead on a difficult project.

Tell me about a time that you led an important meeting.

Video Link

Provide a link to a short video clip expressing why the candidate is deserving of the Serge Payer Foundation Scholarship

Scholarship Information

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Serge Payer Foundation

3101 NW 126th Ter

Sunrise, FL 33323

Info@sergepayerfoundation.org

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WelcomePlease fill out and submit your scholarship application online

Graduates of Rockland District High School

Scholarship Application

Name & Address

School

Leadership

Navigation

Welcome

Please fill out and submit your scholarship application online