Scholarship Application

Please fill out the following form and upload the required files. When finished, please complete your application process by clicking the Submit Now button. After submission you will be routed to a “Successful Submission” page and receive an email confirming submission has been completed. Note that the applicant and sponsor should both be descendants of Nathaniel Dickinson (1600-1672). The sponsor may be the second of the three required recommenders (see item 3 (b) below).

Academic year for which this application is intended.*

First Name*

Last Name*

Telephone*

Street Address 1*

Street Address 2

Town / City*

State*

Postcode / Zip*

Email*

Sponsor Name*

Sponsor Street Address 1*

Sponsor Street Address 2

Sponsor Town / City*

Sponsor State*

Sponsor Postcode / Zip*

Accredited colleges or universities to which you have applied.

College/University Name*

Accepted?*

Yes

Awaiting response

College/University Name

Accepted?

Yes

Awaiting response

College/University Name

Accepted?

Yes

Awaiting response

(Optional) Please list any other colleges to which you have applied.

Please enclose the following:

Transcripts of your most recent two or more years of academic work. At least one transcript file is required.
A 250-300 word essay in which you provide information about yourself, your accomplishments, your educational and career goals, and the value of this scholarship to you.
Three letters of recommendation: (a) from a teacher or administrator of your current or most recently attended school, (b) from a Dickinson Family Association member (usually the sponsor listed above), and (c) from someone who knows you well but not in an academic or family context (e.g. an employer, a clergyman, a leader of an organization to which you belong, etc.)
Evidence of acceptance to an accredited academic institution as a regular full-time student in a degree program. Photocopies are acceptable.
Your family lineage, traced back at least to an entry in the book, DESCENDANTS OF NATHANIEL DICKINSON?

Please note, only the following file types will be accepted:
PDF, DOC, DOCX, XLS, XLSX, JPG, JPEG, PNG, TIFF,

1a. Upload your Transcript file here.

1b. Upload your Transcript file here.

1c. Upload your Transcript file here.

2. Upload your essay here.

3a. Upload Letter of Recommendation 1.

3b. Upload Letter of Recommendation 2.

3c. Upload Letter of Recommendation 3.

4. Upload evidence of acceptance to at least one university.

5. Upload your family lineage.