Scholarship Application

If you answer no to the next 4 questions you will not be able to proceed with the application.

To proceed with this application, you must fulfill the following criteria: acceptance by one of our strategic partners, residence within the specified Northeast Georgia Counties, and identification as a female applicant demonstrating financial need. Please ensure that all questions on the application are answered thoroughly and comprehensively. You may use AI to assist you with completing this application but if is it used for more than 80% you will be immediately disqualified from the scholarship.

1: The Ashton Hope Keegan Foundation’s charter is to provide scholarships and material support to women (with a financial hardship) pursuing either their GED, Certification (ie. Technical 2 year Certification Training within the NE Georgia area). I certify that I am a female seeking financial support to attend technical training with one of our partners.(Required)

Yes

2: To be eligible for the Ashton Hope Keegan Foundation scholarship, please confirm that you satisfy the geographical criteria specified in the Foundation's charter. The Foundation serves women in the following counties: Banks, Barrow, Clarke, Elbert, Franklin, Greene, Hart, Jackson, Madison, Morgan, Oconee, or Oglethorpe County.. Do you affirm that you currently reside in one of these designated counties?

Yes

3. In what county do you reside?(Required)

4: Have you been accepted into a formal training/certification program? We do not provide scholarships directly to students, but instead provide the money in the students’ names to the educational institutions.(Required)

Yes

5: What is your start date?(Required)

MM slash DD slash YYYY

6: Please upload proof of acceptance or enrollment. (Please upload official acceptance letter here)(Required)

Max. file size: 8 MB.

7: Name(Required)

First Last

8: Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

9: Birth Date(Required)

MM slash DD slash YYYY

10: Email (Personal)(Required)

11: Phone Number (Personal)(Required)

To help us better understand our target audience, would you please answer the following questions?

12: Which of these best describes you?(Required)

Asian or Pacific Islander

Black or African American

Hispanic or Latino

Multiracial or Biracial

Native American or Alaskan Native

White

A race/ethnicity not listed here

Prefer not to Answer

Other

12a: If other, please list here

13: Highest level of education completed or partially completed.(Required)

Some High School

High School Diploma

GED

Technical or Occupational Certificate

Associates Degree

Some College Coursework Completed

Bachelor's Degree

Other

13a: If other, please explain here

14: Where have you been accepted?(Required)

Athens Technical College

Connect Care Medical Training Institute

Innovative Healthcare Institute

Medical Institute of Northeast Georgia

One Breath CNA

14a: Please specify the program of study to which you have been accepted.(Required)

15: Please share your total household income, including support from others(Required)

Less than $10,000

$10,000-$19,999

$20,000-$29,999

$30,000-$39,999

$40,000-$49,999

$50,000-$100,000

$100,000 or more

15a: Please let us know if you are the primary contributor to household expenses or are classified as a dependent within your household.(Required)

Primary contributor

Dependent

16: Are you seeking this scholarship for financial support, material assistance, or both? Please select one of the following options. (If your applied program includes materials, please choose scholarship only)..(Required)

Scholarship Only

Material Assistance Only

Both Scholarship and Material Assistance

17: If you have selected 'Material Assistance Only' or 'Both Scholarship and Material Assistance,' please describe your specific needs, directly related to this course of study, in the box below. Examples -Textbook: $100-300(per textbook, depending on subject and edition); Scrub Set (top & Bottom): $20-$50 (per set); Veterinary Vaccinations: $50-$150(Required)

Materials support will be disbursed exclusively to the school or program. We do not offer funding directly to individual applicants for materials.

18: Are you currently receiving or have you applied for any financial assistance (e.g., food stamps, housing vouchers, grants, scholarships, WIOA, WIC, SNAP, Medicaid, TANF, disability, veterans benefits)? If applicable, also note any applications or eligibility for educational benefits from government or private programs.(Required)

19: Are you currently employed?(Required)

Yes

20: If you are employed, please provide employer name & job title.(Required)

For Example: Piedmont Healthcare, Unit Secretary

20a: What is your compensation? Hourly rate of pay, monthly income, yearly income.(Required)

For Example: Hourly Rate $18/hour; Monthly Income $2880; Yearly income $34,560

20b: Hours worked per week: Specify the number of hours you work per week.(Required)

21: If you answered no to being employed, please provide your last 2 years employment and/or educational history.(Required)

22: Please provide information regarding the number of individuals in your household who rely on the income specified above to meet their financial needs. Include all dependents, such as children, elderly relatives, or other family members for whom you provide financial support. This will help us understand your household's financial responsibilities and will assist us in comprehending your financial requirements for this scholarship.(Required)

23: What significant experiences or events have shaped your life? Give details to help us better understand more about you including your education, life and career goals.(Required)

24: What challenges and/or obstacles have you faced in pursuing your educational goals? How have you overcome them? Please explain.(Required)

25: What financial hardships are preventing you from achieving your educational and employment goals?(Required)

26: Tell us about your biggest accomplishment in pursuing your educational and/or employment goals?(Required)

27: What educational or employment achievements are you most proud of?(Required)

28: Are you involved with any community service and/or volunteer work? How might you use this scholarship opportunity and use your new skills and training to make an impact in the community in the future?(Required)

29: If you were to be chosen for the scholarship, would you be willing to speak to others about your success to encourage them to also succeed?(Required)

Yes

30: The program will not release information about you, your whereabouts, or photos to anyone without your consent. Please select one of the choices below.(Required)

The program has my permission to utilize my photos on the website and/or in media releases.

I would like to opt out and not have my photo on the website or in media releases.

31: How did you learn about this scholarship?(Required)

Instructor

Career Coordinator

Website

Other

31a: If other, please list here

Signature (Your typed name serves as your signature. I declare that all information provided in this application is true, complete, and accurate to the best of my knowledge. I further affirm that I have not utilized more than 80% artificial intelligence in formulating my responses. I understand that any misrepresentation or omission of information may lead to disqualification from consideration for this application.)

Date

MM slash DD slash YYYY

Please review and make sure you have thoroughly answered all the questions in the application prior to submitting. If all questions are not thoroughly answered, your application will not be reviewed for consideration.

To proceed with this application, you must fulfill the following criteria: acceptance by one of our strategic partners, residence within the specified Northeast Georgia Counties, and identification as a female applicant demonstrating financial need.

Scholarship Application

If you answer no to the next 4 questions you will not be able to proceed with the application.

To help us better understand our target audience, would you please answer the following questions?

Please review and make sure you have thoroughly answered all the questions in the application prior to submitting. If all questions are not thoroughly answered, your application will not be reviewed for consideration.

To proceed with this application, you must fulfill the following criteria: acceptance by one of our strategic partners, residence within the specified Northeast Georgia Counties, and identification as a female applicant demonstrating financial need.

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