Apply Here

The $4,000 award will be distributed in yearly increments based on the awardee’s educational plan. Verification of continuing education will required at the beginning of each academic year.

To qualify you must:

Be a current high school senior on track to graduate in June 2022
Be continuing your education beginning Fall 2022 (college, university, trade school or other)
Currently live OR go to school in the ‘Target Area’ (see map at bottom of the home page)
Have demonstrated a commitment to improving your community (through involvement in school, home, faith center, neighborhood groups, or as an individual)

Completed applications must include:

Completed and signed application form (including typed short-answer questions)
Official School Transcript
Acceptance Letter from proposed institution of study
Two Letters of Recommendation (MUST be submitted directly by recommenders)

Completed applications and recommendations due Friday, May 20, 2022.

Recommendations must be emailed directly from recommender to kbrown@goldenberggroup.com and received no later than Friday, May 20, 2022.

If you have any questions about the application, eligibility, or award itself, please contact Kiana Brown at kbrown@goldenberggroup.com or 267-225-7214.

Applicant Information:

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Email *

Phone *

Gender *

Male
Female
Prefer not to answer
Other

If "Other" please state here.

Preferred Pronouns *

He/His
She/Her
They/Them
Other

If "Other" please state here.

Expected High School graduation Spring 2022? *

Reside within target area? *

Attend high school within target area? *

NOTE: Applicants must live OR attend school in target area and must be a resident of the City of Philadelphia. See map on home page for area boundaries.

If "Other" please state here.

Cumulative Grade Point Average *

A
B
C
D or below

If your GPA is less than a B, please explain why below.

Primary Parent(s) or Guardian(s) Information:

If parents/guardians have separate addresses or phone numbers, please provide information for only the parent(s) or guardian(s) you would like us to contact.

Name

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Primary Parent(s) or Guardian(s) Information:

Name

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

High School Transcript

Click or drag a file to this area to upload.

Please upload a copy of your most recent high school transcript here.

Acceptance Letter

Click or drag a file to this area to upload.

Please upload of a copy of the acceptance letter to the institution you plan to attend in the Fall 2021.

Eligibility

Please initial the following:

I am currently a high school senior (12th grade) and am on track to graduate at the culmination of the 2021/2022 academic year. I have been accepted and/or am already enrolled in an institution to further my education in the Fall of 2022.

Initial here *

If selected, I will use the award toward my educational expenses in the coming years. Checks will be made out to the institution of higher learning I attend or made out to me personally to cover education-related expenses outside of tuition. (A member of the PWTC Scholarship Committee will discuss this with you if you are selected as an awardee.)

Initial here *

Applicant Signature *

Date *

Essay Questions

Please answer all essay questions below. Answers MUST BE TYPED. Suggested length for each question is approximately 500 words. Reminder: This award is specifically for those who have demonstrated a commitment to community and plan to continue to positively impact their community in the future.

1. The word “community” has many meanings. It can refer to a neighborhood, a school, or a group of people with shared beliefs or life experiences. Think about the different communities of which you are a part. How have you made a positive impact in one or more of these communities? Include details about your role and highlight any leadership you currently provide or have provided in the past.

Answer essay question #1 here *

2. Describe a problem or issue affecting one or more of your communities which you want to help resolve. How will your secondary education better equip you to be a part of the solution?

Answer essay question #2 here *

OPTIONAL: Please list additional information you believe may impact the committee’s decision. For example, have you faced particular challenges in your life? Have you received other awards or acknowledgements? Do you participate in any extracurricular activities or hold jobs outside of school?

Answer optional question here

Letters of Recommendation

Please provide two letters of recommendation. At least one letter must be from a teacher or school counselor. Letters must be sent from recommender directly to Kiana Brown at kbrown@goldenberggroup.com.

Statement of Truth

1. The information submitted on this application is true, accurate and complete to the best of my knowledge.
2. I understand that a representative of the Park West Town Center Community Scholarship Committee may ask me to confirm or verify the information I’ve disclosed in this document during the application process.
3. I understand that if any of the information on this application is determined to be incomplete or untrue, at the sole discretion of the Park West Town Center Community Scholarship Committee, I will be ineligible for consideration of the award.

Applicant Signature

Date