International College Counselors Scholarship Entry Form

Student Information
Student's Name*
First Last
Grade*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Current School Information
School Name*
School Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
School's Phone*
Guidance Counselor's Name*
First Last
Guidance Counselor's Email*
I hereby certify: 1) I have read the rules of this essay contest; 2) This essay is my own work product; 3) I understand that my essay will not be returned to me and will become property of International College Counselors and that the judges decisions are final; 4) I am eligible to enter this contest, and if selected, able to be recognized as a winner of this contest.
Applicant's Signature*
Today's Date*
MM slash DD slash YYYY
Student's Age
Is the student under 18 years old?*
- Yes
- No
Parent / Guardian Signature
If the entrant is less than 18 years old (a “minor entrant”), then a parent or legal guardian of the minor entrant must sign below, which signature shall certify that such parent or legal guardian (i) confirms that all statements made above with respect to such minor entrant are true and accurate and (ii) makes the same consents, waivers, releases and other statements on behalf of itself and its minor entrant, as are set forth above.
Guardian Name*
First Last
Guardian E-Signature
Today's Date*
MM slash DD slash YYYY
Upload Essay
Upload Your Essay*
Accepted file types: doc, docx, pdf, pages, rtf, Max. file size: 512 MB.
500 words or fewer. Allowed file types: doc, docx, pdf, pages, rtf.
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Yes! I want to receive the latest information about college admissions. Add my email address to the International College Counselors (ICC) mailing list. ICC does not share or sell your personal information.
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International College Counselors Scholarship Entry Form

Student Information

Current School Information

Student's Age

Parent / Guardian Signature

Upload Essay

College Admissions Opt-In