The Jewish Guild for the Blind

Please review this application before submitting. The Scholarship Committee will review only those applications that are complete with required supporting documents and meet all scholarship criteria.

Attention: If you encounter trouble submitting this application or need assistance, please call 212-769-7801 or email guildscholar@jgb.org.

* required

I. Personal Information

Name: *
Date of Birth (mm/dd/yyyy): *
Address: *
City: *
State: *
Zip/Country Code: *
Phone: *
Names of Parents/Guardians: *
E-mail: *
U.S. Citizen/Legal Resident? *	(Yes/No)

Vision Diagnosis
What are the primary and secondary diagnoses causing your vision loss (for example Leber Congenital Amaurosis, Glaucoma, ROP, Stargardt disease, etc.)

Primary Diagnosis: *
Secondary Diagnosis:

II. Educational Background

A. School In Which Currently Enrolled:

Name of Current School: *
Address: *
City: *
State: *
Zip/Country Code: *
Contact Name: *
Phone: *

B. Test Scores and GPA:

High School Cumulative Grade Point Average: *
College Admission Test Scores ACT: *
SAT Verbal: *
SAT Math: *
SAT Writing: *
SAT Total: *

C. Colleges/Universities to which you have applied or will apply: * All college admissions policies must be non-denominational and open to applicants of all religions, faiths and beliefs.



D. Leadership/Community service: *



E. Awards and honors: *



F. Extracurricular activities: *



G. Financial circumstances: (optional)
Include any special information that you would like the scholarship committee to consider.



III. Documentation (to be attached)
Click the 'Browse' button to select a file.
Our system accepts files up to 300 KB in size. Your files must be in the DOC, TXT, PDF, JPG, or TIF format and must not contain apostrophes ( ' ) in the file name.

Official Transcript: *
Proof of Legal Blindness: *
Proof of US Citizenship/Residency: *
SAT / ACT Results: *
Letter of Recommendation 1: *
Letter of Recommendation 2: *
Letter of Recommendation 3: *

IV. Personal Statement
Please attach a personal statement, not exceeding 500 words in Word or PDF format. The statement should describe your educational and personal goals.

Personal Statement 1: *

V. Statement about an Influential Teacher
Please attach a statement in Word or PDF format. The statement should describe the influence of an outstanding teacher on your education and/or personal development.

Teacher's Statement: *

Posted Date:

Attention: Upon clicking the "Submit Application" button below, there will be a pause while your documents are uploading. Please be patient as this can take up to a couple minutes depending on your connection speed. Upon successful submission, you will arrive to a confirmation screen and a confirmation email will be sent to you. If you do not receive this email confirmation, please call 212-769-7801 or email guildscholar@jgb.org.