Maxwell Scholarship Application for Academic Year 2019-20

Please see and read carefully the Guidelines before completing the Scholarship Application.

* All Fields are Required

First Name  
Last Name  
Home Address  
Home City  
Home State  
Home Zip  
Home Phone    
Mobile Phone  
College Choices (If you have not selected the college you will attend, list the private colleges between which you are choosing.):
High School  
SAT Scores or ACT Composite Score:
Reading:  Math:  Writing:  or  ACT :
Class Rank (eg: 4 / 400)  
Honors and Awards
Briefly describe in a numbered list format (i.e. 1., 2., 3...) significant scholastic distinctions or honors you have won, beginning with ninth grade.

For the following 3 items, please create Word Documents or PDF files and upload them to our server by clicking the "Browse..." buttons.
Extracurricular, Personal and Volunteer Activities  
List your principal extracurricular, personal, volunteer, community and family activities and hobbies in the order of their importance and interest to you. Place an asterisk (*) by those that were associated with or sponsored by your school. For each activity, please indicate (1) the grade levels you participated, (2) the average hours per week and weeks per year you devoted to that activity and (3) leadership positions you held and honors and letters you received.

Please use the format of the attached form (.docx , .pdf) to report your information.
 (.pdf, .doc or .docx only)
Work Experience  
List jobs you have held (including summer jobs) during the last three years.
 (.pdf, .doc or .docx only)
Personal Statement  
Write an essay that will help us to have a better understanding of who you are as a person and a student and that will demonstrate your ability to organize your thoughts and express yourself. Please limit your essay of approximately 250 to 500 words. Please choose ONE of the following topics:
  1. Evaluate a significant experience, achievement, risk you have taken or ethical dilemma you have faced and its impact on you.
  2. Discuss an issue of personal, local, national or international concern and its importance to you.
  3. Indicate a person who has had a significant influence on you and describe that influence.
  4. Describe a character in fiction, an historical figure, or a creative work (such as art, music, science, etc.) that has had an influence on you and explain that influence.
 (.pdf, .doc or .docx only)
Please hit the "Submit" button only one time. Do not leave this page while your files are being submitted. You will receive a 'Thank you' message when the submission is complete.

  I represent that I am at least 13 years of age or that my parents have consented to my submitting this application. If I am under 13 years of age, my parents are emailing their written, signed consent to my submission of this application to