The Arkansas Dyslexia Support Group (ADSG) i s committed to supporting students with dyslexia,
markers of dyslexia, o r characteristics of dyslexia as they transition from high school into post-
secondary education, training, or employment preparation.
This scholarship is intended to assist graduating seniors who have demonstrated perseverance and
determination in overcoming learning challenges related to dyslexia.
Funds may b e used for a variety o f purposes that help the student succeed after graduation,
including but not limited to:

• College o r university tuition
• Trade or technical school programs
• Certification programs
• Specialized tools or equipment for employment or training
• Assistive technology
• Books or educational materials
• Other post-secondary expenses that support success
• Any expense related to enlisting in any branch of the US military
  Important Dates
• Application Deadline: April 15
• Award Notification: On or before May 15
• Submission: Applications may be submitted electronically or by mail.
  Eligibility Requirements
  Applicants must:

1. Be a graduating high school senior in Arkansas.
2. Have dyslexia, markers of dyslexia, or characteristics consistent with dyslexia (formal diagnosis not
   required).
3. Plan to pursue post-secondary education, training, certification, o r employment preparation after
   graduation.
4. Demonstrate perseverance, determination, and commitment to personal growth.

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Applicant Information

Name *

First

Last

Email *

Birthday

Have scholarship today.

Phone

Address

Address Line 1

Address Line 2

City

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Zip Code

High School or Home School *

• High School
• Home School

Expected Graduation Date *

Dyslexia Background

Have you been formally diagnosed with dyslexia? *

• Yes
• No

If diagnosed, who made the diagnosis? *

• School
• Education evaluator
• Medical professional
• Other

Post-Secondary Plans

What are your plans after high school? *

• Four-year college/university
• Community college
• Trade or technical school
• Certification program
• Workforce training
• Other

Name of school/program (if known)

Intended field of study, trade, or career path:

Scholarship Use:

If selected, how would you use the scholarship funds? (Check all that apply) *

• Tuition
• Books
• Assistive technology
• Tools or equipment for trade or career
• Housing or transportation
• Certification or training costs
• Other

Please briefly explain how the scholarship would support your goals:

Personal Essay

In 300-500 words please answer the following: Describe how dyslexia or learning challenges have shaped who you are today. How have you overcome obstacles, and how will your future plans help you succeed? Briefly describe how dyslexia or related learning differences have impacted your educational experience. *

Activities and Achievements: *

List any activities, work experience, leadership roles, or community involvement. *

References (2/3). Please provide at least one reference from a teacher, counselor, employer, or community leader (name, title, relationship, phone or email: *

Certification:

I certify that the information in this application is accurate to the best of my knowledge. *

• Yes I certify

Your Signature

Clear Signature

Parent/Guardian Signature (if under 18):

Clear Signature

Date Signed

Submit

Submission Information:
Completed applications must be submitted by April 15.

Scholarship recipients will b e notified on o r before May 15.