Entry Form
**The 2018 Resident Scholarship Program Entry Form is currently closed. All completed forms are being reviewed and all applicants will be notified by email if they have been selected as a potential winner on or about Friday, May 4, 2018.

For any questions, please email us at scholarship@housingcenter.com.

Resident Scholarship Program Details

Awards are $6,000 each and are issued only to your educational institution before the 2018 fall academic term.
A total of 12 scholarships will be awarded.

Scholarship payments are made directly to the college, university, or technical school by Housing Authority Insurance, Inc. and are deposited into an F.B.O. (For the Benefit Of) Account. Scholarship award proceeds are to be used only for tuition, books, or school supplies.

Potential winners who have been selected will be asked to provide additional information. You will become a winning recipient only after that information is received.

The check will be sent once the completed Proof of Enrollment Form and W-9 form for the recipient's school for the 2018 fall academic term have been received by Housing Authority Insurance, Inc.

The selected candidate must expend all award proceeds during their chosen institution’s 2018 fall academic term. If there are any unused award proceeds after the completion of the 2018 fall academic term, we reserve the right to withdraw those proceeds from the institution.

Should you have questions or need more information, please e-mail us at scholarship@housingcenter.com.

Section One

Please download each of the forms below before moving on to Section Two of the Entry Form.

Forms to Download:
1. 2018 Affidavit –
Download form here

*Read: This form must be filled out and signed by the applicant or the applicant’s guardian if under the age of 18

2. Proof of Residency
Form –
Download form here

*Read: This form must be filled out and signed by the applicant’s landlord/housing agency

3. Proof of Enrollment Form –
Download form here

*Read: This form must be filled out and signed by the applicant’s school

4. W-9 Form –
Download form here

*Read: This form must be filled out and signed by the applicant’s school

Upload Affidavit Form:*
Upload Proof of Residency Form:*
Upload Professional Headshot or Photo of Applicant (JPG or PNG format)*
Upload Proof of Enrollment Form:
Upload W-9 Form:
Note: In order to be eligible for this scholarship, you must be a United States resident.

For all applicants who have not yet enrolled in the 2018 fall academic term, please note that you will not need to upload the Proof of Enrollment Form and W-9 Form at this time. If an applicant is selected as a potential winner, he or she will have 14 days upon receiving notice from Housing Authority Insurance, Inc. to provide the completed and signed (by the school) Proof of Enrollment Form and W-9 Form.
Section Two 
First Name*
Last Name*
Middle Name
Street Address*
Street Address Line 2
Zip Code*
Home Phone*
Cell Phone Number*
E-Mail Address*
School Level Going Into (Fall 2018)*
Number of Years Until Graduation*
Are you a US Citizen?*
Name of sponsoring housing agency:*
Is this:*
Section Three

Before submitting this entry form, make sure you review the below information and sign off that you did so. Incomplete entries will not be entered into the drawing. You will not be contacted if your entry form is incomplete.

Have you:
1. Completed and signed entry form (all sections) including uploading all required forms.
2. Read the privacy policy and agree to its terms.
Download privacy policy here.
3. Read the official rules and agree to the terms and outline.
Download the official rules here.
4. Read the frequently asked questions. 
Download the FAQ here.
Please indicate yes or no:*