2024 Alpha-1 Educational Scholarship Application

alpha1.org

Alpha-1 Educational Scholarship Requirements
1. Applicants agree to be added to the mailing list of the Alpha-1 Foundation (A1F), which is confidential and never shared with outside organizations, and receive occasional A1F mailings. Please click the link below and submit, then return to this form. [Subscribe to Alpha-1 Foundation](https://alpha1.org/subscribe/)

2. Recipients agree to have their picture and short bio published in the Alpha-1-to-One Magazine for that scholarship year and other potential A1F publications, including the A1F website.

3. Recipients agree to participate in potential follow up discussions and/or meetings regarding the Alpha-1 community and involvement opportunities with A1F.

4. Recipients may be asked to participate in future A1F program and/or planning committees.

5. Recipients may be asked to raise awareness for Alpha-1 by sharing A1F social media content.

6. Deadline: Applications must be submitted by **April 1, 2024** to be considered.

Scholarship Application Uploads

Your application MUST include the following to be considered:

1. Completed Alpha-1 Educational Scholarship application.

2. Upload a copy of the applicant’s ACT/SAT scores (If not taken, please explain).

3. Upload most recent high school transcripts for incoming freshmen or college transcripts for continuing students.

4. Documentation of applicant’s high school or college GPA [if it is included on most recent transcripts, it is acceptable].

5. A 500-word essay explaining the lessons you have learned from Alpha-1 Antitrypsin Deficiency (Alpha-1) and how it has impacted you as an individual.

6. High resolution headshot [in jpeg form].

Applicant Email

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Last Name

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First Name

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Middle Name or Initial

Applicant Birth Date

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Applicant Street Address

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City

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State

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Zip Code

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Applicant Telephone

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Full Name of Related Alpha

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Related Alpha's Relationship to Applicant

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Parent

Grandparent

Self

Sibling

Child ( you are the parent of a child that has Alpha-1)

Annual Family Income

Income - (This section is used to determine need if multiple applicants are being considered. Blank or "0" will not be accepted)

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Year in College During Coming Year

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Freshman

Sophomore

Junior

Senior

Graduate

College You are Attending/Planning to Attend

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Address of College, City, State, Zip Code

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Full Time Student

If the answer is "NO," please select "Other" and write in the number of credits you have completed.

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Major Course of Study

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Current Overall GPA

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Upload a clear copy of your current Transcripts *

SAT/ACT Score *

Upload a clear copy of your ACT/SAT Scores

If you do not have ACT/SAT scores, Please explain

School and Community Activities:

List each Activity on a single line with the Number of Years and the Role and Accomplishments (past 4 years)

Example: Singer - 3 years - Soprano/Church Choir

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Work Experience

List each job on a single line with Employer, Nature of Work and Dates and Hours a Week (past 4 years)

Example: Home Depot - Cashier - 15 hours a week.

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Service to the Alpha-1 Community

Please describe your involvement in the Alpha-1 community.

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Career Goals

Please describe your future career goals.

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How did you hear about Alpha-1 Scholarships?

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500 Word Essay explaining the lessons you have learned from Alpha-1 Antitrypsin Deficiency (Alpha-1) and how it has impacted you as an individual (Please do not explain what Alpha-1 is). *

High resolution headshot [in jpeg form] *

Certification:

By clicking Submit below, I hereby affirm that the information provided on this form is accurate and complete to the best of my knowledge. I agree to the Alpha-1 Educational Scholarship Requirements outlined above.

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2024 Educational Scholarship Application

Scholarship Application Uploads

2024 Educational Scholarship Application