Scholarship renewal requests start here…

About You

First Name *

Middle Name *

Last Name *

Permanent Mailing Address (indicate if mailing address is different) *

City *

US States *

Zip *

Date of birth *

Email *

Phone *

Mother's Full Name

Father's Full Name

Do you live with your parents? *

If yes, how many children are dependent on your parents?

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Financial Information

Gross family income (from last year’s income tax return) *

Are you receiving veterans benefits: *

If yes, how much to do you receive?

Have you received any other financial aid or scholarships? *

Please list the source, type (e.g. grant or loan), and amount of aid *

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Education

College you attend *

College's Address *

City

US States

Full-time or part-time status? *

Full-time (9+ credit hours per semester)
Part-time (6-8 credit hours per semester)

Student Type: *

Graduate
Undergraduate

If you are transferring, list the name of the college you plan on transferring to: *

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Additional Information

Do you authorize me to share this application with community groups that provide scholarship opportunities… yes or no? Your response will not impact this application.

PERSONAL REASONS FOR SCHOLARSHIP *

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Upload your transcript and supplemental materials here.

File Upload

STUDENTS: I certify that the above information is full, complete and true to the best of my knowledge. I also hereby acknowledge that completion of this application does not guarantee a scholarship award, due to limits on award funds. Scholarships will be awarded by Delegate Lisanti with recommendations from her Scholarship Committee based on academic performance and need.

PARENT: I certify that the above information is full, complete and true to the best of my knowledge. I also hereby acknowledge that completion of this application does not guarantee a scholarship award, due to limits on award funds. Scholarships will be awarded by Delegate Lisanti with recommendations from her Scholarship Committee based on academic performance and need. Copy *

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Application Checklist

All of the following is included within this application. Supplemental materials or other required documents must be EMAILED, FAXED, or MAILED with the Student's full name on each additional component so the application files can be compiled. *

Most up to date copy of your transcript. (Does not need to be an official transcript)
Have MD CAPS account https://mdcaps.mhec.state.md.us
All sections of the application completed
Remember - you must re-apply and complete an application each year (email request for renewal application MaryAnn.Lisanti@house.state.md.us)

Renewal Scholarship Applicant

Renewal Scholarship Applicant

About You

Financial Information

Education

Additional Information

Application Checklist