Scholarship Form

Looking for Mahanay Student Loans or other scholarships?

Home State Bank Scholarships

Home State Bank scholarships are open to graduating high school seniors. Applicant and/or parent (guardian) must have a banking relationship with Home State Bank. Application deadline is March 15.

Applicant Information

* - Indicates required fields

First Name *

Middle Initial *

Last Name *

Address *

City *

State *

ZIP *

Phone *

Date of Birth *

Email *

Parent(s)/Guardian(s) *

Father's Occupation *

Mother's Occupation *

Educational Information

High School *

Expected Graduation Date *

Cumulative GPA (Based on a 4.0 scale) *

Class Rank: *

Total Students *

College or University you have been accepted to and plan to attend *

What will be your major area of study? *

Activities

List a maximum of seven activities and your level of participation in each (offices held, committees, awards, etc.). Activities may include school, extracurricular, community or religious activities, etc.

Activity *

Essay * Briefly state your future education plans and career goals. (Maximum 500 words)

Reference Letter * Please submit one reference letter from a teacher or community member.

Transcript * Please submit a copy of your high school transcript.

Photo * Please upload a picture to be used for publicity should you be awarded.

Signatures

I authorize Home State Bank to publicize the scholarship award along with my picture if I am a recipient. I certify that this application is accurate and completed to the best of my knowledge.

Applicant *

Parent/Guardian Signature*

Scholarship Form

Looking for Mahanay Student Loans or other scholarships?

Home State Bank Scholarships

Activities

Signatures

Get In Touch

Resources