Scholarship Application

Fill it out below, then print or save as a PDF to email.

Complete this application on screen, then use Print / Save as PDF to produce a copy — or print it blank and fill it in by hand. Email your completed application, your high school transcript, and a letter of recommendation to Jody Richter. All applications are due on or before June 1.

Eligibility criteria

Must be a child of a Licking County Bar Association member.
Must be a high school graduating senior pursuing post-secondary education at an accredited college or university.
Must have a minimum 3.5 grade point average on a 4.0 scale.

Award up to $2,000

Application requirements

Type or print clearly and complete the entire application, including the essay.
Attach a copy of your high school transcript (an unofficial transcript is acceptable).
Attach a letter of recommendation.

Applicant contact information

First name

M.I.

Last name

Date of birth

Email address

Street address

City

State

ZIP code

Home phone

Cell phone

Work phone

Parent — Licking County Bar Association member

Parent's name

Parent phone

Parent email

Applicant education information

Name of high school

Anticipated graduation date

GPA

Class rank

SAT or ACT composite score

Sports, clubs, or extracurricular activities you participate in

Awards & honors

Awards, honors, etc. you have received in high school

College or university information

Academic year I plan to attend

College / university

Intended start date

City, state

Degree sought and/or course of study

Work & volunteer experience

Volunteer and/or community service activities — include a brief description of the activity and your role

Work and/or internship experience

Essay Please limit to under 500 words. Describe your current plan and major of study for college, why you chose that path, and what you look forward to as a future career.

Your essay — you may type it here, or attach it on a separate document

How to submit

Email your completed application to Jody Richter at jrichter.lawoffice@gmail.com (save this form as a PDF, or scan a completed handwritten copy).
Email a copy of your high school transcript (an unofficial transcript is acceptable).
Email a letter of recommendation.
All applications are due on or before June 1.

Email Jody Richter Choose “Save as PDF” in the print dialog, then attach it — with your transcript and recommendation letter — to your email.