HOME ABOUT US EVENTS VOLUNTEER ADMISSIONS CONTACT
SECTION ONE: DEMOGRAPHIC INFORMATION
* Student's Name:
* Student's Address:
* Student's Phone Number:
* Email:
* Social Security #:
* High School:
* Grade:
* Gender: Male   Female
Student ID:
* D.O.B.:
I consider myself: (pick one) College Bound
Work Bound
Military Bound
* Parent's Name(s):
* Parent's Email:
List programs/services in which financial assistance is needed:
Total cost for these programs/services? (attach details)
How did you hear about us? Web
Email
Flyer
Friend
Other, Please Specify
SECTION TWO: FINANCIAL INFORMATION
(List all sources of income and amounts. Please give total for One Year.)
1. DPA $
2. Social Security $
3. Unemployment $
4. Insurance/Pension $
5. Dividends/Interests $
6. Alimony/Support $
7. Food Stamps $
8. Other Income $
9. Savings $
Proof of income for ALL adults in the home will be required. (i.e., pay stubs (3 recent paystubs), DPA/SSI award letter, etc. Additional information may be needed for more substantial scholarship amounts.

If applicable, attach a summary of an unusual experience or circumstances that will support your request for a scholarship.
 

GIRL'S WORK Student Application Drop Deadline
12:00 Midnight
Thursday, January 31st
The Lenfest Center 3890 N. 10th St. Philadelphia, PA 19140

GIRL'S WORK Orientation & Lunch
12:00pm - 2:00pm
Saturday, February 9th
The Lenfest Center 3890 N. 10th St. Philadelphia, PA 19140

7900 Germantown Ave
Rear Suite
Philadelphia PA 19118
P: (267) 258-8479
F: (215) 247-1444


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