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Eighth Grade Scholars Application

All fields with an asterisk (*) are required.
A. General Information

B. Academic Information
C. Reference Letters

By submitting this form you acknowledge that two reference letters must be included with this application. One letter should be from a school staff member such as a teacher, counselor or principal. The other letter should be from another adult outside the school who is not your parent or guardian (examples include: church leader, adult friend or neighbor, etc.). All letters must be returned to the student in a sealed envelope to be submitted to their guidance counselor.

D. Family Support

This scholarship requires ongoing family support for the student’s efforts to be a successful recipient of the financial and academic aid provided by the program. The Clark State Foundation must have access to the student’s academic records. The signature of the parents or guardian below serves as permission to release the child’s academic records to the Clark State Foundation. This signature also serves as verification that the student meets the eligibility requirements of the free or reduced school lunch program and that neither parent/legal guardian (including step-parent) has an associate’s or higher level college degree, at the time of this application. Lastly, this indicates that Clark State Foundation has the right to take photographs at Scholars’ events including mentoring sessions for public use on social media and publications.


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Scholars Program Director Sara T. Landess Technology and Learning Center