Pam King HAEA Scholarship Application

THE SPRING 2023 APPLICATION IS NOW CLOSED

Please read this application carefully as some of the requirements have recently changed.

Applications may only be submitted during the dates noted below:

Fall Semester

February 1 – March 31: Applications Accepted
May 1: Award Announcements

Spring Semester

August 1 – September 30: Applications Accepted
November 1: Award Announcements

Requirements to submit an application:

A physician's statement noting applicant's HAE diagnosis (not required for reapplicants)
Letter of recommendation (not required for reapplicants)
Current Federal Tax Return or FAFSA Summary Report with adjusted household income (required for applicants and reapplicants)
A Video testimonial (required for applicants and reapplicants)

Please Note: After completing this online form, you will receive a confirmation email with additional instructions on how to submit your transcripts, a video testimonial, and a school administrator or professor recommendation.

Your application will not be complete until we receive all components. If you have questions, please email us at haescholarship@gmail.com.

**APPLICATIONS FOR SPRING 2023 IS NOW CLOSED**

If you have completed two or more semesters of college, please enter the name of that college instead of your high school information below.

Do you feel that your grades are an accurate index of your ability? If not, what circumstances do you feel have affected your scholastic record?

School Name for which you are applying for the scholarship (if different from above)

Name of any other Scholarships/Grants/Financial Aid Programs applied for (including amount)

Please upload a current resume. If you have any problems uploading, please email it to haescholarship@gmail.com.

All applicants (including reapplicants) are required to provide their most recent Federal Tax Return or FAFSA (Free Application for Federal Student Aid) Summary Report. To obtain the report, visit https://fafsa.ed.gov. If you have any problems uploading, please email it to haescholarship@gmail.com.

Please upload physician's statement noting applicant's HAE diagnosis. (Not required for reapplicants.). If you have any problems uploading, please email it to haescholarship@gmail.com.

By signing below, the applicant certifies that all statements submitted are true and correct, that they believe that they are eligible to apply for an Pam King HAEA Scholarship.

According to the Federal Family Rights and Privacy Act of 1984, no information about a student's academic performance may be disclosed without the written consent of the student (if they are 18 years of age or older) or the consent of their parent (if the student is under the age of 18).

Therefore, to complete the Pam King HAEA Scholarship Program Application, a signature must be provided prior to the school registrar/principal/guidance counselor providing the additional information required by this application.

Applicant Signature (By entering my name and today's date in the fields below, I provide an electronic signature of consent and agreement.)

Parent/Guardian Signature, if applicant is not yet 18 (By entering my name and today's date in the fields below, I provide an electronic signature of consent and agreement.)

All information submitted is for the sole use of the Pam King HAEA Scholarship Committee to determine award recipients. Information contained and submitted with this application will be kept confidential and will not be used for any other purpose.