Slate Belt Rising Scholarship

Slate Belt Rising Scholarship
Qualifications:
The Slate Belt Rising Scholarship Program was created to provide students the opportunity to further their education and help defray the cost of post-secondary education. In order to apply for this scholarship, candidate must:
1. Be a Bangor or Pen Argyl high school senior who has been accepted at a four-year university/college, community college, technical school, or is entering the workforce in a trade; an adult that is continuing their education.
2. Have a grade point average of 3.0 or better (on a 4.0 scale).
3. Have verifiable volunteer experience within the past two years.
4. Have membership and/or leadership experience in clubs and organizations.

Please note: DEADLINE FOR APPLYING IS APRIL 8, 2026
Email*
example@example.com
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Date of Birth*

MonthDayYear
Date
GPA*
Parent's Email*
example@example.com
Which college/university/technical school will you be attending?
What is your field of study?
Anticipated date of college graduation?
Have you secured employment in the trade? If so, please provide company name and contact information.
Please list any awards and/or scholarships you have received.
Please list any volunteer experiences over the past two years and include the name of the organization and phone number. *
Describe your membership and/or leadership experience in clubs and other organizations.*
The following attachments are required. Please make sure your name is included in each attachment file name.

For example: RosenblumActivities.doc

Please write a personal statement of 250-500 words that answers one of the following prompts. Be sure to include specific examples and experiences to illustrate your points.

Option 1: Community Impact

Slate Belt Rising is dedicated to improving the Slate Belt region by fostering comprehensive community and economic development. How have you contributed to you community through volunteer work, leadership roles, or other activities? How do you plan to use your education or career to positively impact the Slate Belt community in the future?

Option 2: Overcoming Challenges

Share a challenge you have faced and how you overcame it. How has this experience shaped your goals and aspirations? How will receiving this scholarship help you achieve them?

Option 3: Vision for the Future

Describe your future career goals and how they align with your field of study. How will receiving this scholarship support your journey, and how do you hope to give back to the community or others once you achieve your goals?
Please attach a 250-500 word essay that answers one of the above prompts.*

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Please attach two letters of reference. One letter should come from volunteer experience.*

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Please attach your home school transcript.*

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Scholarship Recipient Demographic Questionnaire

Slate Belt Rising, a program of Community Action Lehigh Valley (CALV), is funded by various grants and private sources. To comply with our funding obligations, CALV is required to provide demographic information about service recipients. Your demographic information is crucial for us to continue providing these scholarships. All personally identifiable information you provide is kept strictly confidential, stored in locked program files, and entered into a secure database hosted in the Microsoft Azure Cloud by Eccovia Solutions, ensuring the highest levels of security, privacy, and data storage compliance.
- WhiteBlack or African AmericanAmerican Indian or Alaska NativeAsianNative Hawaiian and Other Pacific IslanderOtherMulti-Racial
- Hispanic, Latino, or Spanish OriginNon-Hispanic, Latino, or Spanish Origin
- YesNo
- YesNo
- 23456 or more
- Income from employment onlyIncome from employment and other income sourcesIncome from employment, other income sources and non-cash benefitsIncome from employment and non-cash benefitsOther income source onlyOther income source and non-cash benefitsNo incomeNon-cash benefits only
- Temporary Assistance for Needy Family (TANF)Supplemental Security Income (SSI)Social Security Disability Income (SSDI)VA Service-Connected Disability CompensationVA Non-Service-Connected Disability PensionPrivate Disability InsuranceWorker's CompensationRetirement Income from Social SecurityPensionChild SupportAlimony or other Spousal SupportUnemployment InsuranceEITCOther
- SNAPWICLIHEAPHousing Choice VoucherPublic HousingPermanent Supportive HousingHUD-VASHChildcare VoucherAffordable Care Act SubsidyOther
- $0-$24,999$25,000-$49,999$50,000-$74,999$75,000-$99,999$100,000-$149,999$150,000+
- I certify that the information provided in this application, including the demographic information section, is true and accurate to the best of my knowledge.
  
  Clear
- I hereby consent and authorize CALV, including its programs (Slate Belt Rising) and subsidiaries, permission to use my likeness in a photograph, video, and/or audio clip in any and all of its publications, including but not limited to CALV's printed and digital publications and social media channels.
  
  I hereby authorize CALV to edit, alter, copy, exhibit, publish, or distribute this photograph, video, and/or audio clip for purposes of publicizing CALV's programs or for any other related, lawful purpose. In addition, I waive the right to inspect or approve the finished product, including a written or electronic copy, wherein my likeness appears.
  
  I acknowledge that since my participation is voluntary, I will receive no financial compensation. Additionally, I waive any right to royalties or other compensation arising out of, or related to, the use of the photograph/video/audio.
  
  The undersigned does hereby release CALV, its successors or assigns from any liability, responsibility, damages, claims, and suits of right-of-action resulting from the reproduction of the undersigned's photographic likeness. If I do not wish to be photographed, I will notify CALV staff immediately upon being awarded a scholarship.
- Applicant's Signature
  
  Clear
- Date
  
  MonthDayYear
  Date
- Signature of Guardian if Under 18
  
  Clear
- Date
  
  MonthDayYear
  Date
- Printed Name of Guardian
  
  First NameLast Name
- Guardian's Email Address
  example@example.com
- Guardian's Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
Should be Empty:

Slate Belt Rising Scholarship

Scholarship Recipient Demographic Questionnaire