IMPACT Multimedia Publishing    
Scholarship Application Packet Essay Requirements

Name:  __________________________________________________
Address: __________________________________________________
                __________________________________________________
Phone:  __________________________________________________
e-mail: ____________@________________._______
High School:____________________grad date*:_____________
G.P.A._______  Class Rank:_____/______
*if future, write anticipated date

Anticipated Major:_______________________________________________
Choice 2:___________________________________________________

Anticipated School:_______________________________________________
Choice 2:___________________________________________________

Check Boxes for all that apply:

FAFSA Forms Complete
Take SAT/ACT Tests
Anticipated School(s) Application Completed
Send Official H.S. Transcripts to IMPACT*
Send Test Scores to IMPACT*
Send (3) letters of Reccomendation*
HIGH School Rank/total graduating	/
Verified by:________________________ Title:_____________________________	Date:

*items can be copied and verified as originals and mailed other scholarship committies.
Questions CONTACT: iphone@indifference.com
Scholarship Recipients must be High School Seniors, with a minimum GPA of 2.0, & a US Citizen.
Based on need and creativity.

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PRINT THIS PAGE AND SUBMIT WITH YOUR APPLICATION (1/3)
Mail Completed Materials to: 4100 17th Street #1, San Francisco, Ca 94114
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