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2026 Stockton Black Fmaily Day Scholarship Application

*First name

*Last name

*Address

*Email

*Phone

*Gender

*Ethnicity

Birthday

Month

Day

Year

*High School Name

*Current GPA

*Graduation Date

*Citizenship

U.S. Citizen

Permanent Resident

Student Visa

Other

*County of birth

*How did you hear about the “BFD” Scholarship?

*Do you have any relatives who are current BFD staff or board members?

yes

no

*Within your family, are you the first generation to attend college?

yes

no

*COLLEGE/UNIVERSITY you plan to attend in Fall 2025 or have applied. Name of School:

*Degree you will be pursuing in Fall 2026

*Have you been accepted to any colleges yet?

yes

no

If so, please list the names and advise which college is your choice

*Have you received any scholastic honors or distinctions? If so, please list?

*Tell us about your involvement with the community, now and in the past.

*List the most significant extracurricular and community activities (sports, art, music, clubs, social or public service etc.) in or out of school, in which you have participated.

*List any internship(s) experience(s) in which you have participated.

*List any work and/or volunteer experience.

*Additional Education | College Background (If you are going to college currently although you have not yet graduated .) How many college Credits to you have and in what areas and your GPA)

*1st PERSONAL STATEMENT: (The statement/essay should include: personal history, academic and professional goals, how can a scholarship benefit you, why should you be awarded a scholarship.

*2nd PERSONAL STATEMENT: Describe a disappointment/challenge you had and what it taught you about yourself.

*Highlight who you are, what you would like us to know about you and your Academic goals.

File upload

If you do not yet have your letters at the time of submission, please email them to info@stocktonjuneteenth before May 27th @ 5pm to be considered. On the subject line, please state "Miss Juneteenth Recommendation letters for "Your Name".

*(1st Reference)Counselor or Teacher First and Last Name:

*Contact Email

*Phone Number

File upload

If you do not yet have your letters at the time of submission, please email them to info@stocktonjuneteenth before May 27th @ 5pm to be considered. On the subject line, please state "Miss Juneteenth Recommendation letters for "Your Name".

*(2nd Reference)Other Adult (not a relative) who knows you well (coach, club advisor, counselor, church or community leader, teacher, etc.) First and Last Name:

*Contact Email

*Phone Number

*I hereby certify that all of the information in this scholarship request form is accurate and complete. I understand that all the information contained in this form will be treated confidentially and will be used for selection purposes only.

I understand and agree

I do not agree

*Signature

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Red Fireworks

TNT Fundraiser

$100

$100 Worth of Fireworks + Free Large Gift
Price$100.00
$80

$80 Worth of Fireworks + Free Medium Gift
Price$80.00
$60

$60 Worth of Fireworks + Free Medium Gift
Price$60.00
$40

$40 Worth of Fireworks + Free Small Gift
Price$40.00
$20

$20 Worth of Fireworks + Free Small Gift
Price$20.00

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San Joaquin Juneteenth Foundation

943 North El Dorado Street

Stockton, CA 95202

Contact Us:

info@stocktonjuneteenth.org

(209) 457-SJJF (7553)

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© 2025 by San Joaquin Juneteenth Foundation Inc. 501(c)(3).

The San Joaquin Juneteenth Foundation is a non-profit 501c3 organization, Tax ID number is 82-2939889.

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