Student Form | Scholarship Vericast

Email

This field is for validation purposes and should be left unchanged.

Before we get started(Required)

I confirm that I am applying for the Vericast Scholarship as a senior in high school.

We can only accept applications for the Vericast Scholarship from those students currently completing their senior year in high school. We ask any students not yet in their senior year to come back when you are a senior to apply.

Applicant Information

Applicant Name(Required)

First Last

Applicant Email(Required)

Enter Email Confirm Email

Applicant Phone(Required)

Applicant Address(Required)

Street Address Address Line 2 City State ZIP Code

Employee Information

Employee Name(Required)

First Last

Employee Title(Required)

Team members with titles of Senior Vice President and above are not eligible.

Work Email(Required)

Work Phone(Required)

Education and Experience

High School Information

School Name(Required)

Graduation Date – Current Year(Required)

School City and State(Required)

City State

School Phone(Required)

Post-Secondary School Information

Name of post-secondary school you plan to attend. (If unknown, please list in order of preference the schools to which you have been accepted.) Use official school names. Do not abbreviate.

School Name(Required)

School City and State(Required)

City State

School Name (second option)

Only use this field if you are unsure of your post-secondary school at time of applying for this scholarship.

School City and State

City State

Type of School(Required)

Anticipated Major Course of Study(Required)

Anticipated Graduation Year(Required)

Work Experience

Work Experience – Describe all work experience during the past four years (e.g., food server, babysitting, landscaping, office work). Indicate dates of employment for each job and approximate number of hours worked each week.

Employer

Position

Date Started

Date Ended

Hours worked each week

Please enter a number greater than or equal to 0.

Employer

Position

Date Started

Date Ended

Hours worked each week

Please enter a number greater than or equal to 0.

Employer

Position

Date Started

Date Ended

Hours worked each week

Activities, Awards and Honors

Activities, Awards and Honors – List all school activities in which you have participated during the past four years (e.g., student government, music, sports, etc.). Note all special awards, honors and offices held.

Activity

Years of Participation

Please enter a number greater than or equal to 0.

Special Awards and Honors

Offices Held

Activity

Years of Participation

Please enter a number greater than or equal to 0.

Special Awards and Honors

Offices Held

Activity

Years of Participation

Please enter a number greater than or equal to 0.

Special Awards and Honors

Offices Held

Activity

Years of Participation

Please enter a number greater than or equal to 0.

Special Awards and Honors

Offices Held

Activity

Years of Participation

Please enter a number greater than or equal to 0.

Special Awards and Honors

Offices Held

Community Service

Community Service – Vericast is a firm believer that all individuals have an obligation to strengthen the communities where we live and work. Please describe your community involvement activities during your high school career. Please quantify the amount of time spent on activities (hours/week, month, etc.)

Organization

Years of Participation

Please enter a number greater than or equal to 0.

Activities

Organization

Years of Participation

Please enter a number greater than or equal to 0.

Activities

Organization

Years of Participation

Please enter a number greater than or equal to 0.

Activities

File Uploads

Essay

Essay – Please submit up to a 500-word response to the following essay question: A range of academic interests, personal perspectives and life experiences add much to the educational mix. Given your personal background, describe a challenge you have faced and how overcoming it has shaped your future goals.

Essay Upload(Required)

Drop files here or

Max. file size: 50 MB.

Additional Consideration

Optional – There may be personal information you would like to be considered as part of your application. This information might include exceptional hardship, challenges or opportunities that may have impacted your academic credentials. You may also want to include any exceptional achievements, talents, or educational goals for consideration as well as any letters of recommendation in this section.

Additional Consideration

Drop files here or

Max. file size: 50 MB.

High School Transcripts

Transcript Information – An official and current transcript of grades must be attached to this application form. A clear explanation of the school’s grading scale must also be shared.

Transcript Upload

Drop files here or

Max. file size: 50 MB.

Explanation if not included

Aptitude Test Scores

Aptitude Test Scores (ACT/SAT) – Formal verification of Aptitude Test Scores (ACT/SAT) must also be submitted with the application. Verification may be a copy from the testing site or screen shot of the test scores. Please be aware student’s name must be visible on scoring information.

Test Score Upload

Drop files here or

Max. file size: 50 MB.

Explanation if not included

Digital Signature(Required)

Please enter your full legal name for our records of your consent.

The application window is now open!

Student Application 2026

Applicant Information

Employee Information

Education and Experience

High School Information

Post-Secondary School Information

Work Experience

Activities, Awards and Honors

Community Service

File Uploads

Essay

Additional Consideration

High School Transcripts

Aptitude Test Scores