Catholic Community Foundation - Give Today ... Impact Tomorrow

Online Scholarship Application Form

Application Deadline:

Thursday, April 15, 2010 by 3:00 p.m. All applications MUST be submitted online this year using the form below. Applications submitted after 3:00 p.m. on that date will not be considered.

Scholarships will be awarded during the Regina Awards Assembly on May 18, 2010. Benefactors and award recipients will be invited to a luncheon held on that same day, hosted by the Regina Foundation.

A majority of our scholarships have a financial need criterion. Financial need is shown by qualifying for financial aid through Regina's Private School Aid Service (PSAS) tuition assistance program. To find out more about the PSAS application process, click here: Regina PSAS

Please read scholarship summaries (K-12th grade students and graduating seniors) and complete all applicable information. Note: college-bound applicants must complete all three sections.

* Indicates Required Field

Section 1 (all Grades)

Date:	*
Name:	*
Address:	*
Email Address:	*
Phone:	*
Current Grade:	*
Cumulative Grade Point Average (GPA): (if applicable)
Ethnicity:
Is your parent a current faculty or staff member of the Regina K-12 Education Center?	Yes No
Parish Affiliation: (parish at which your family is registered)
Community Sponsored Activities (Scouts, 4-H, Fall Fun Volunteer, etc.)
School Sponsored Activities (Class Officer, Athletics, Music, Drama, etc.)
Church Sponsored Activities (Altar service, Free Lunch Volunteer, etc.)

Demonstrated Christian Values at Home, Church, School or Community



Please state why you feel the Scholarship Committee should award this scholarship to you. Please limit your response to 300 words preferred.* If the applying student is currently in 6th grade or above, we request the student personally compose this short essay for the application to be considered for scholarship.




*Financial need is shown by qualifying for financial aid through Regina’s Private School Aid Service (PSAS) tuition assistance program. Please click on the following statement signifying agreement.

I have utilized the Private School Aid Service (PSAS) application process at Regina and hereby authorize the Regina Business Office to acknowledge my receipt of financial aid towards tuition. I/We understand that if the above statement is not selected, the applicant will not be considered for a need-based scholarship.

If you are not a college-bound applicant, continue to Section 3. Some college-bound scholarships require additional information. See specifics listed below.

Section 2: College Bound Applicants Only

College-Bound Applicants Only: Regina Faculty Recommendation (if you wish to be considered for the David Braverman Scholarship)	Will be mailed to Catholic Community Foundation, P.O. Box 1581, Iowa City, IA 52244-1581 (must be postmarked no later than April 15, 2009).
College-Bound Applicants Only: Name of college/university or vocational program you will attend (verification of enrollment must be presented to the Foundation office if you are awarded a scholarship)
College-Bound Applicants Only: Planned Major
College-Bound Female Applicants Only: List demonstrated leadership, scholarship and compassion qualities throughout your high school years (if you wish to be considered for the Kathleen Dore Scholarship for Women Leaders)
College-Bound Applicants Only: State why you chose to attend a Jesuit college (if you wish to be considered for the Brendan Fisher Memorial Scholarship)

Section 3: Parent Approval (all grades)

Signature of parent

Parent present while filling out form

Signature of parent

Parent present while filling out form

YOU MUST CLICK SEND ON THE NEXT PAGE ONCE YOU HAVE CONFIRMED YOUR INFORMATION. YOU WILL RECEIVE A CONFIRMATION BY EMAIL. IF YOU DO NOT RECEIVE AN EMAIL CONFIRMATION, PLEASE CONTACT THE REGINA FOUNDATION AT 319-354-5866 OR info@icreginafoundation.com.

Note: You may need to scroll down and/or to the right to get to the SEND button on the confirmation page.

* Indicates required fields