First name Student's first name
Last name Student's last name
Email Student's email address
High school graduation year 2015 or earlier 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036 2037 2038 2039 2040 2041 Student's high school graduation year. E.g., class of 2026
Country United States Canada Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil British Indian Ocean Territory British Virgin Islands Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Croatia Cuba Curaçao Cyprus Czech Republic Cote d'Ivoire Congo, the Democratic Republic of the Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong SAR Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau SAR Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova, Republic of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Qatar Romania Russian Federation Rwanda Réunion Saint Barthélemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Holy See (Vatican City State) Venezuela Vietnam Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe
State/Province Alabama Alaska Alberta Arizona Arkansas British Columbia California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northwest Territories Nova Scotia Nunavut Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Yukon
ZIP code
Are you a U.S. resident? Yes No Are you a U.S. resident as defined by the IRS (https://www.irs.gov/individuals/international-taxpayers/determining-an-individuals-tax-residency-status)?
Do you identify with any particular race(s) and/or ethnicity(ies)?
Family Adjusted Gross Income <$35,000/year $35,001 - $55,000/year $55,001 - $75,000/year For more information on how to find this information, please visit the FSA website: https://studentaid.gov/help-center/answers/article/adjusted-gross-income-agi
High school name
Video essay How would being an IvyWise Scholar help you achieve your goals? (Please provide a 1- to- 2-minute-long video response via a YouTube, Vimeo, or Google Drive link with appropriate permission settings.)
Essay What are your college goals — and what have you done thus far to achieve those? (Maximum of 1,500 characters.)
Extracurricular activities
Academic interests What are your main academic interests and ideal college major(s)? (e.g., Are you more STEM-focused? Or interested in the humanities?) Tell us about your academic pursuits, your favorite courses, and why you are passionate about them.
GPA Please include both your weighted and unweighted GPAs, if applicable. If your high school provides class ranks, please also share that information.
Standardized test scores Please list any ACT/SAT/AP/IB/etc. test scores you've received.
Top three institutions you are planning on applying to
Anything else you'd like us to know about you/your application? E.g., caring for relatives, doing household tasks, experiencing homelessness, or anything else that has impacted your educational experience.
How did you hear about IvyWise? Internet/Web Search Event/Speaking Engagement Word of Mouth Advertisement Media Appearance/Article Social Media Podcast
Please provide more information on how you heard about the IvyWise Scholars program E.g., "[School name] + [Teacher name]"
Parent/Guardian first name
Parent/Guardian last name
Parent/Guardian email
Parent/Guardian relationship Assistant Father Guardian Mother Parent Relative Other Counselor/Administrator
Comments
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