Your High School Transcripts:
Your SAT and/or ACT High School Report:
Have you been notified of your acceptance
to this school?
What is your Class Rank? [Numbers only:  1, 2, 3...]:
I am
out of
Tell us about your school activities... List in order of importance to you:
First Choice
Fourth Choice
Fifth Choice
Second Choice
Please upload your Test Scores, your High School Transcript in PDF format. Also, upload your photo at this time. Please use the following Naming Convention when naming your files:
Third Choice
Ex:  JohnSmith-ACTreport-JohnMall.pdf
Ex: MaryJones-Photo-Laveta.jpg
Have you made formal
application for admission
to this school?
Ex:  John Smith-Teach-LaVeta.pdf
Number of Children in the Family [Including you...]:
Have you received special recognition for any of the above activities?. If so, please describe:
Your Birth Order:
Your Personal Information
Please tell us about your activities in the community and your church:
Mother's Name:
Applicant Signature
City, State and Zip:
Telephone Number:

If you are selected to receive one of the Cuchara Chapel Scholarships, the Scholarship Committee would like to present the scholarship check to you during one of the Chapel's summer services.

The committee believes this will help make the scholarship rewarding more personal as well as encourage those present tin the service to be more genrerous in their underwriting of future scholarships.

Therefore, please indicate your FIRST, SECOND, THIRD, FOURTH AND FIFTH choice of dates you could be present.

Important:  If you select a service on a Sunday when there are TWO services, please indicate the service time your prefer to be present.

If you are unable to be present on any of the above dates, include a statement of explanation as to why this is the case.
High School Name:
Tell Us About Your Family...
Father's Name
Mother's Occupation:
Father's Occupation:
Tell Us About Your High School...
Please Answer The Following Short Essay Questions...
Why do you think you deserve a scholarship?
Tell us about the nature
of your financial need:
What are your
plans for college?
What are your plans for a career after college?
Please provide three references and obtain a Letter of Reference from each of them:
Fill in the requested information, then upload each Letter of Reference in PDF,
using the following naming convention:
A teacher who knows you well
A family member
A member of the community
Teacher's Name:
City, State and Zip:
Upload Reference Letter:
Upload Reference Letter:
City, State and Zip:
Family Member's Name:
Community Member's Name:
City, State and Zip:
Upload Reference Letter:
Please tell us the name and address of the college or university you plan to attend.
Scholarship Presentation at The Cuchara Chapel...
Your Photo:
Your Employment...
What employment,
if any, have you had in
the last two years?
Your College or University Choice...
Upload Your Documents...
Your Signature... 
Please fill in all of the information requested.
Name of College or University:
City and State:
Review for Completeness and Accuracy...
Before signing your name below, please go back to the top and review your entire application to be sure it is complete and your answers are what you intended. Look for Fill-in-the-blank, "Select" Drop-down menus and File Uploads to ensure accuracy.

When you are done, type your name below in the signature box, affirming that the information is true and correct. You will see a confirmation page and receive an email when the process is complete.

Mandatory Scholarship Application Form
The Cuchara Chapel Scholarship
Cuchara, Colorado