Step 1 of 2 50% Applicant's Name* First Last Last 4 Digits of Applicant's Social Security Number* Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Telephone (Cell)*Texting allowed?* Yes No Telephone (Home)Applicant's Student Email* Applicant's Personal Email Applicant's Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code My involvement with DCP&P is best described as: (Please only select one answer.)* Out-of-Home Placement Adoption Kinship Legal Guardianship Other If other, please explain:Supportive Contact Name* First Last Supportive Contact Email Address* Supportive Contact Phone* You must upload your high school transcript and personal essay with your initial application. All other attachments must be submitted to swhite@embrella.org within 14 days and are required for application to be considered. Please submit all attachments as .pdf, .jpg, .png, .doc, or .docx files only. ■ Letter of support/recommendation (personal/character) ■ Letter of support/recommendation (academic) ■ Confirmation of at least one other source of funding [e.g. verification of employment or intended employment, award letters for other scholarships already received, proof of application to the Free Application for Federal Student Aid (FAFSA)] ■ Letter of acceptance or proof of application to an accredited college or vocational school. Some awards are contingent upon acceptance. (This item is not applicable for youth applying to the Opportunity Grants to assist with independent living only.) ■ Copy of high school transcript or GED ■ Detailed spending plan—(If awarded a scholarship or grant, what would you use the funding for?) ■ Essay – Describe how an influential person or experience in your life has shaped your future goals. Please upload the files listed above here:* Drop files here or Select files Max. file size: 300 MB. I give embrella permission to reprint my application essay and if awarded, my thank you letter. I understand my name will not be used* Yes No By clicking below, I verify my case history experience was in New Jersey and through NJ Division of Child Protection and Permanency CP&P (formerly DYFS) HiddenRecord Type Automation Δ