2026 Chamber Foundation Scholarship Application **Applicant MUST live and/or study in the Mid-Hudson Valley (counties of Columbia, Dutchess, Greene, Orange, Putnam and Ulster) For more information about the specific residency requirements of each scholarship at www.dcrcoc.org/scholarships The deadline to submit applications is April 10, 2026. A complete application includes: — a complete application form; — a resume — an essay (see specific essay requirements for each scholarship); — your most recent high school and/or higher education transcript (if you are a current college student, please submit your college transcript). Please email to foundation@chamberfdn.org by April 10, 2026. — a copy of your Student Aid Index (SAI) number which you receive when you complete your Free Application for Federal Student Aid (FAFSA); — and two current letters of recommendation from someone who is familiar with your educational goals, skills and abilities but is not a family member. They may be from a teacher, coach, guidance counselor, employer, clergy, or person other than a family member who is familiar with your skills and abilities. Please email to foundation@chamberfdn.org by April 10, 2026. *IMPORTANT* If you are a high school freshman, sophomore or junior, please immediately stop filling out the application as you are NOT eligible for any scholarships. Scholarship recipients are permitted to use scholarship dollars towards tuition ONLY, if awarded, the dollars will not be permitted to be used for supplies, books, or other items. * I acknowledge __________________________________________________________ Applicant's Information: First Name * Middle Name * Last Name * Date of Birth * Format: mm/dd/yyyy Preferred Pronouns Physical Address Line 1 * Physical Address Line 2 City * State * Select option... NY Applicant MUST reside in NY Zip Code * Mailing Address Line 1 Leave blank if the same as Physical Address Mailing Address Line 2 Leave blank if the same as Physical Address City Leave blank if the same as Physical Address State Select option... NY Leave blank if the same as Physical Address Zip Code Leave blank if the same as Physical Address County of Residence * Have you lived in the above County for at least 5 years? * Select option... Yes No Daytime Phone * Email * __________________________________________________________ Family Information Primary Parent/Guardian Information First Name * Middle Name * Last Name * Job Title/Employment Status * Email * Daytime Phone * Parent/Guardian Marital Status * Select option... Single Married Cohabiting Separated Divorced Widowed Other Secondary Parent/Guardian Information First Name Middle Name Last Name Job Title/Employment Status Email Daytime Phone Parent/Guardian Marital Status Select option... Single Married Cohabiting Separated Divorced Widowed Other __________________________________________________________ How many siblings do you have? * Select option... 0 1 2 3 4 5 6 7 8 9 10+ If you do have siblings, how many are currently attending college? * Select option... N/A 0 1 2 3 4 5 6 7 8 9 10+ __________________________________________________________ Current Education Level* What is the last full year of education level you completed? * example: High School Senior, 1st year college, 2nd year college, etc. GED* Are you working on or have you achieved your GED or High School Diploma? * Select option... GED/ High School Equivalency Diploma High School Diploma None Are you currently enrolled in school? * Select option... Yes No What is the name of the school you are currently enrolled in? * Date of High School Graduation/Diploma Enter the date of your High School Graduation, High School Withdrawal, or completion of High School Equivalency Diploma * Format: M/d/yyyy Have you been out of high school for 5 years or more? * Select option... Yes No What is your class rank? (if available) What is your class size? (if available) What is your High School/GED/College Cumulative GPA? * What is your SAT total score? (if applicable) What is your SAT Evidence- Based Reading & Writing score? (if applicable) What is your SAT Math score? (if applicable) What is your ACT Composite score? (if applicable) __________________________________________________________ Higher Education Do you CURRENTLY attend college as an undergraduate student? * Select option... Yes No What college are you currently enrolled in? What school(s) are you considering? * What is the name of the college/school for which scholarship aid is requested? * __________________________________________________________ College Major/Minor What is your current or expected field of study? * What is the length of time to complete this course of study? (number of years) * Select option... 1 year 2 year 3 year 4 year 5 year 6 year plus The type of school I plan to attend next year is _____ * Select option... a four- year college or university a two- year college a vocational or technical school a graduate school none of the above I will be enrolled _____ * Select option... full time half time or more less than half time I will live ______ * Select option... on campus off campus at home Cost of Tuition for 1 year * Tuition only; do not include other expenses. If you are considering more than one school, enter the higher tuition cost. __________________________________________________________ Financial Information Should your scholarship be awarded, you will be required to provide the following documentation: Your Student Aid index (SAI) number, which you will receive when you complete and submit your Free Application for Federal Student Aid (FAFSA). Please provide the most recent 2 Years of Tax Returns for yourself and/or a parent/guardian based on how you file. Student Aid Index (SAI) number * Adjusted Gross Income (for yourself AND/OR your parent/guardian) * Taxable Income (for yourself AND/OR your parent/guardian) * Information may be found on Line 22 of IRS form 1040 or line 6 of IRS form 1040EZ. *If parents/guardians file separately, combine and enter the total for both here. *ALL* parent(s) and/or guardian(s) must be included, as well as yourself. Are you receiving any additional support to aid you in paying for higher education? * Must include ALL contributions from family members, other scholarships (please include the intended amount), funds, grants (Federal Supplemental Educational Opportunity Grant (FSEOG), etc. Do you, or a member of your household currently receive financial assistance? * Examples. SNAP, Medicaid, NYS TAP, Supplemental Security Income (SSI), etc. Are you planning on taking out a subsidized or unsubsidized loan to pay for your continued education? * Select option... YES NO For a Subsidized Loan, you will not be charged interest while you’re in school, during your grace period, or during other periods of deferment. With an Unsubsidized Loan, interest will accrue on your loan as soon as it is disbursed, even while you are in school. Describe any special personal, financial, emotional, physical, developmental or family obstacles which affect your financial resources that you would like the Committee to take into consideration in reviewing your application. Examples: job changes, housing changes, family illness, caregiving, etc. Additional Notes Use this additional space to explain or elaborate on any of the previous questions that you would like to provide more information about to the Committee. __________________________________________________________ SUPPORTING DOCUMENTATION The supporting documents are required. Accepted file format: PDF only Employment, Extracurricular Activities, and Volunteer Work Have you been employed (paid work) within the last year? This includes being a baby sitter, life guard, cashier, landscaper, etc. * Select option... Yes No Resume Before uploading your resume, please be sure to include the following relevant information: Name or organization/Employer, title/position held (paid or unpaid) and responsibilities, the month and year started and ended (if no longer working there) and approximate hours per week, extracurricular activities, volunteer and community service work, awards and honors that you received. Applicant's Resume * UPLOAD HERE (PDF only) Do you plan on being employed while studying for your degree? * Select option... Yes No __________________________________________________________ Consent & Certification If applicant is under the age of 18, a parent/guardian MUST give consent. Student Certification I, as the applicant, confirm that I am over the age of 18 and consent the release of my name and image(s) for any scholarship received to the media and for publication. I certify that the information on this form is true and complete to the best of my knowledge. * Select option... I am over the age of 18 and I consent I am under the age of 18 and cannot consent Enter Applicants Full Name * By typing in your name, you confirm consent to the above. Parent/Guardian Certification If applicant is over the age of 18, and certified above, you may skip this confirmation. I, as the Parent/Guardian, confirm that I am over the age of 18 and consent the release of my student's name and image(s) for any scholarship received to the media and for publication. I certify that the information on this form is true and complete to the best of my knowledge. Select option... I consent Enter Parent/Guardian Full Name Skip if not applicable. By typing in your name, you confirm consent to the above. __________________________________________________________ Which scholarship(s) are you applying for? Check ALL that apply. * Cosimo DiBrizzi Culinary Arts Scholarship (General Essay) Eileen Hickey Nursing Scholarship (General Essay) Juan Lafuente Leadership Scholarship (General Essay) Richard W. Mitchell Memorial Scholarship (General Essay AND Overcoming Obstacles Essay) Jeffrey B. Senft Memorial Scholarship for the Trades (Trades Career Essay) Linda and Steven Lant Family Scholarship (Overcoming Obstacles Essay) Essays Upload all essay files in Adobe Acrobat (PDF) format only. GENERAL ESSAY: Discuss your career goals, personal values and community services. The essay should not exceed 500 words. Required - ESSAYS THAT DO NOT ADDRESS THE TOPIC WILL NOT BE CONSIDERED. General Essay Upload * Please upload your separate PDF file by selecting the "choose file" button above. OVERCOMING OBSTACLES ESSAY: To be completed for Richard W. Mitchell Memorial Scholarship and Steven and Linda Lant Scholarship ONLY Describe how you overcame or are coping with obstacles in your life (personal, financial, emotional, family, educational, economic, physical, developmental, etc.) and your future aspirations. The essay should not exceed 500 words. ESSAYS THAT DO NOT ADDRESS THE TOPIC WILL NOT BE CONSIDERED. Overcoming Obstacles Essay Upload Please upload your separate PDF file by selecting the "choose file" button above. TRADES CAREER ESSAY: Applicants are asked to write a 500-word essay explaining why they are insured in pursuing a career in the trades. Trades Career Essay Upload Please upload your separate PDF file by selecting the "choose file" button above. __________________________________________________________ Transcripts/GED/High School Diploma In order to be considered for a scholarship, a copy of your most recent high school and/or higher education transcript must be sent directly to: foundation@chamberfdn.org no later than April 10, 2026. NOTE: If you are a current college student, please submit your college transcript. __________________________________________________________ Letters of Recommendations You are required to provide 2 letters of recommendation. They may be from a teacher, coach, guidance counselor, employer, clergy, or person other than a family member who is familiar with your skills and abilities. Send directly to: foundation@chamberfdn.org no later than April 10, 2026. __________________________________________________________ -Before You Submit Your Application- Before clicking 'Submit' below, please ensure you have thoroughly reviewed the information you provided, including personal and financial information, uploading your resume and essay(s), as well as making a note to send your transcript and 2 letters of recommendation to foundation@chamberfdn.org no later than April 10, 2026.
