Application Eligibility for
High School Graduates

For eligible graduating high school seniors attending 2-year
or 4-year undergraduate, trade or technical college

Application Deadline

Fully completed application is due no later than March 15, 2026, 11:59 PM Pacific Time.

GJS Scholarship Eligibility Requirements

1. You are an African-American high school senior from:
   • Southwest Georgia (the 14 counties of:
Baker, Calhoun, Colquitt, Decatur, Dougherty, Early, Grady, Lee, Miller, Mitchell, Seminole,
Terrell, Thomas, or Worth)
   • or the San Francisco Bay Area (the 9 counties of: Alameda, Contra
Costa, Marin, Napa, San Francisco, San Mateo, Santa Clara, Solano, or Sonoma).
2. And, you are college-bound, graduating high school spring of this year.


GJS Scholarship Selection Criteria

1. You clearly demonstrate a need for financial aid (provide latest parent’s Tax Return Summary).
2. Your transcript shows an upward trend in grades and course load during high school
3. Both your Short Answer and Personal Essay submissions are original, well-written, answer the
 topic prompts, and provide a glimpse of your unique personality and perspective.
4. The reference letters speak specifically to your strengths and abilities.
5. Application is fully completed by the student, submitted on time, and free of
 errors.
6. Scholarship recipients need to confirm college of attendance before funds will be awarded.


Annual Scholarship Details

• Scholarship awards are typically between $500 to $2,000, increasing each academic year. Scholarships do not automatically renew — prior recipients may reapply each year of subsequent enrollment. Funds are sent directly to your school’s financial aid office to be applied to your student account.


Before you begin, write your Personal Essay

Your personal essay is vital to determining your scholarship eligibility, by demonstrating writing skills and the ability to express yourself in a concise manner. (Want some writing tips? See our College Essay Writing Tips here.)

• Write your Personal Essay on the topic below (400-600 words).
• Have your essay proofread for correct spelling, punctuation, grammar, and structure. 
• Save your Personal Essay in PDF or Word format for upload.

TOPIC: Please share a challenge in life that you have encountered, what you did to overcome the challenge, and the lesson(s) learned that you will take forward in your life.

…and write your Short Answer

• Write out your Short Answer to the topic below (80-100 words).
• Have it proofread, and ready to copy and paste into the application.

TOPIC: Describe a small moment or everyday experience that has shaped your perspective on your community. How has this influenced your goals for the future?

GJS Application for High School Seniors

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– Step 1 of 8

GJS Application for Graduating High School Seniors

(for eligible African-American high school seniors graduating Class of 2026, attending 2- or 4-year undergraduate, trade, or technical college)

Before You Start:
Gather all your uploadable required documents (PDF, PNG, JPG, Word doc accepted) such as: 
• your portrait photo
• parent’s most recent income Tax Return Summary (2024 or 2025)
• high school transcript (unofficial okay)
• your personal essay
• two letters of reference
• college financial aid award letter/info

To move forward in the application:
1. Complete all required fields (asterisk* means required).
2. Click Continue.
3. You can Save and Return Later if you need to take a break. Save the link provided — you will need it to resume. When you resume, your entries will be saved, but you must re-upload any documents previously uploaded.

Application Deadline:
Fully completed application is due no later than March 15, 2026 at 11:59PM Pacific time.

Please confirm before continuing:

I am an African-American High School Senior from: *

• SOUTHWEST GEORGIA: (the 14 counties of:
Baker, Calhoun, Colquitt, Decatur, Dougherty, Early, Grady, Lee, Miller, Mitchell, Seminole,
Terrell, Thomas, or Worth)
• SAN FRANCISCO BAY AREA (the 9 counties of: Alameda, Contra
Costa, Marin, Napa, San Francisco, San Mateo, Santa Clara, Solano, or Sonoma)

Select which one applies to you.

Confirm the following: *

• I have read the above information, and confirm that I understand and meet all the application eligibility requirements.

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STUDENT INFORMATION

Last Name *

Middle

First Name *

Address *

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Email *

Provide a long-term email, not a school one that can expire.

Birthday *

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Student ID or SSN *

College Student ID (or last 4 digits of Social Security Number)

Student Cell Phone Number *

Home Phone Number

Are you a first generation college student? *

• Yes
• No

$ Total 2025 Student Annual Income *

Include wages or other taxable income.

Deceased Parent(s)? *

• Yes
• No

Optional: Tell us more

If you like, add more info about the deceased parent and the impact on your college financial situation.

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PARENT / HOUSEHOLD INFORMATION

Provide parent or guardian information unless one of the following situations applies to you:

Parent / Guardian Exception Situation

• I am legally emancipated or considered an independent student
• I am unable to provide parent or guardian information doe to estrangement or safety concerns
• Other (please explain

Please explain your situation *

Provide a brief explanation so we can understand your situation.

Total 2025 Parent/Guardian Adjusted Gross Income (AGI) *

Enter the total combined annual income for parent(s) or guardian(s) (i.e., 45,000)

Parent / Guardian Federal IRS Tax Return Summary

Please upload the most recent available Federal IRS Income Tax Return Summary (2024 or 2025), showing Adjusted Gross Income (AGI).

— If parents or guardians file jointly, upload their combined return summary.

—If they file separately, upload both return summaries.

A Tax Return Summary (or Transcript) can be requested online through your parents’ IRS account or by calling the IRS 800-908-9946. This information will be handled confidentially. For privacy, do not provide your parents’ social security numbers.

Upload Parent/Guardian IRS Tax Return Summary(s) showing AGI *

Drag & Drop Files, Choose Files to Upload You can upload up to 4 files.

If you instead choose to upload the first pages of Tax Return(s) or W2 Wage & Tax Statement(s), be certain Social Security numbers and other sensitive information have been redacted (removed).

PARENT / GUARDIAN 1 INFORMATION

Last Name *

Middle Initial

First Name *

Cell Phone Number *

Home Phone Number

Optional

Email *

Occupation / Employer Type *

Example: Teacher, Retail Manager, Self-Employed, Unemployed

Employment Status *

• Employed full-time
• Employed part-time
• Self-employed
• Unemployed
• Not currently working (student, caregiver, etc.)

Additional Employment Status

• Retired
• Disabled
• Receiving disabiity benefits

Optional: Please check all that apply.

College/University Attended (if applicable)

Degree(s)

Year

Housing Status *

• Own Home
• Rent
• Other Living Arrangement

Select the option that best describes the parent’s or guardian’s current living situation.

Marital Status *

• Married
• Divorced
• Separated
• Single

Do you have another parent or legal guardian to list? *

• Yes
• No

PARENT / GUARDIAN 2 INFORMATION

Parent 2 Last Name *

Parent 2 Middle Initial

Parent 2 First Name *

Cell Phone Number *

Home Phone Number

Optional

Email *

Parent 2 Occupation / Employer Type

Example: Teacher, Retail Manager, Self-Employed, Unemployed

Parent 2 Employment Status *

• Employed full-time
• Employed part-time
• Self-employed
• Unemployed
• Not currently working (student, caregiver, etc.)

Parent 2 Additional Employment Status

• Retired
• Disabled
• Receiving disabiity benefits

Optional: Please check all that apply.

Parent 2 College/University Attended (if applicable)

Degree(s)

Year

Housing Status

• Own Home
• Rent
• Other Living Arrangement

Select the option that best describes the parent’s or guardian’s current living situation.

Marital Status

• Married
• Divorced
• Separated
• Single

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HIGH SCHOOL ACADEMICS

Name: Your High School *

City *

State *

Class Rank *

Class Size *

GPA *

GPA Weighted *

• Yes
• No

Did you take the SAT? *

• Yes
• No

SAT Exam Date

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Please complete the following SAT information.

SAT Critical Reading Score

SAT Math Score

SAT Writing Score

SAT Total Score

SAT Subject Test (if any)

Score

SAT Subject Test 2

Score SAT Subject Test 2

Did You Take the ACT? *

• Yes
• No

Please complete the ACT information.

ACT Exam Date

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ACT Comp Score

ACT English Score

ACT Math Score

ACT Reading Score

ACT Science Score

ACT Writing

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EXTRACURRICULAR ACTIVITIES AND INTERESTS

Please list each extracurricular activity separately, the high school year of participation & approximate number of hours for each activity. TO ADD another activity, CLICK the + sign on the right.

Extracurricular Activity or Interest

High School Yr(s)

Number of Hours

Email APPLICATION Year

Honors / Awards Received

Please list each Honor / Award separately. TO ADD another activity, CLICK the + sign on the right.

Name of Honor / Award

Clubs and Associations

Clubs and Associations

List Clubs and Associations here.

Volunteer Work and Community Service

List each one separately. T0 ADD another one, CLICK the + sign on the right.

Name of Service/Volunteer Work

High School Years

Number of Hours

Part-Time or Full-Time Jobs Held

Please list each one separately. TO ADD another one, CLICK the + sign on the right.

Job Name

Multiple Choice

• Full Time
• Part Time

Number of Hours

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COLLEGE / UNIVERSITY AND FINANCIAL AID INFO

College or University You Plan to Attend *

Major/Career Goal *

$ Total Cost to Attend *

Financial Aid Counselor *

Phone Number *

Email *

$ Total Estimated Financial Aid Package *

Refer to your school’s acceptance letter and/or preliminary financial aid award letter for this information.

Financial Aid Office Address *

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

TRANSCRIPT Upload (unofficial is OK): PDF, PNG, JPG *

Drag & Drop Files, Choose Files to Upload You can upload up to 3 files.

$ Upload 2026 Financial Aid Award Letter (PDF, JPG, PNG) *

Drag & Drop Files, Choose Files to Upload You can upload up to 2 files.

Upload a copy of your 2026-2027 Financial Aid Award letter from the college or university you will be attending.

Upload 2 Letters of Reference (PDF, JPG, PNG) *

Drag & Drop Files, Choose Files to Upload You can upload up to 3 files.

Upload Your Profile Photo (JPG, PNG) *

Drag & Drop Files, Choose Files to Upload

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TYPES OF FINANCIAL AID YOU WILL BE RECEIVING

I Will Be Receiving These Types of Financial Aid (check all that apply) *

• College/University Scholarships (need-based or merit)
• Federal Scholarships/Grants (i.e.,Pell, Hope, Merit, SEOG)
• Student Loans
• Work-Study
• Outside Scholarships
• N/A

Check all that apply. Then complete the information below. If none apply, check N/A

College/University Scholarships (need-based or merit) *

C/U Scholarship Status *

• Accepted
• Pending

$ C/U Sch Amount *

Federal Grants (for example: Pell, Hope, Merit, SEOG) *

Fed Sch/L Status *

• Accepted
• Pending

$ Fed Sch/L Amount *

Student Loans *

Loan Status *

• Accepted
• Pending

$ Loan Amount *

Work-Study *

Work-Study Status *

• Accepted
• Pending

$ Work-Study *

Outside Scholarships and Financial Aid Name

Please list each Outside Scholarship or Financial Aid separately. TO ADD another one, CLICK the + sign on the right.

Specific Outside Scholarship *

Outs Sch/FA Status *

• Approved
• Pending

$ Outside Sch/FA Amt *

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ESSAYS: SHORT ANSWER, PERSONAL ESSAY

Short Answer — 80 to 100 Words

Short Answer: 80 – 100 Words

In the space below, answer the following:

Describe a small moment or everyday experience that has shaped your perspective on your community. How has this influenced your goals for the future?

Enter Your Short Answer Here *

Personal Essay: 400 – 600 words

Personal Essay: 400-600 Words

Upload your original essay (in Word or PDF) on the topic below. This personal essay is vital to determine scholarship eligibility, demonstrating writing skills and ability to express yourself in a concise manner.

Be sure to have your essay proofread for correct spelling, punctuation, grammar, and structure.

Topic: Please share a challenge in life that you have encountered, what you did to overcome the challenge, and the lesson(s) learned that you will take forward in your life.

Upload your Personal Essay (Word Doc or PDF) *

Drag & Drop Files, Choose Files to Upload You can upload up to 3 files.

SUBMIT YOUR APPLICATION

Read and Sign Waiver

By submitting this scholarship application, you acknowledge that all information provided is true and accurate.

Incomplete applicationas will be disqualified, so be sure to answer ALL fields.

If you don’t have the exact information,  provide an estimate or explanation.

Please allow 8-10 weeks for the Board’s selection of scholarship recipients.

All information provided will be viewed only by administrators and Gaines-Jones Board of Directors.

And I agree, if awarded a scholarship, that my photo may be used on the Gaines-Jones.org website and other collateral.

Age Verification of Applicant/Parent or Guardian *

• I am over 18 or the legal guardian of the participant above and I accept the terms of this waiver.

Your Birthdate

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Your Signature *

Clear Signature

Date Signed *

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