Scholarship Application

Required*
- I understand I am required/expected to attend the scholarship ceremony on July 20, 2024 from 1-3 PM as part of my application.
- I understand I am required to either be a resident of Illinois (attending any school), or an employee of The Chicago Lighthouse.
Personal Information
Name*

First

Last
Phonetic Spelling of First & Last Name
Gender Identity*
Address*

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code
Phone*
Email*
Date of Birth*

Month

Day

Year
If you received a Chicago Lighthouse Scholarship in the past, please indicate which year(s) you were a recipient. Or you can say, First Time Applicant.*
*You cannot be awarded a scholarship more than four years in a row. However, you may reapply after a one year gap. After a one year gap period, you will be eligible again for four more consecutive scholarships.
Describe yourself:*
Please check all boxes that apply.
- Visually Impaired (best corrected visual acuity of 20/70 or worse in the better eye)
- Legally Blind (best corrected visual acuity of 20/200 or worse in the better eye)
- Totally Blind (no light perception in both eyes)
- Visually Impaired/Blind and Multi-Disabled (meeting one of the above vision related criterion with the presence of an additional documented disability, such as a physical disability, deafness, cognitive impairment or chronic health condition)
- CLH Employee with one of the above vision impairments
- CLH Employee with another documented disability
- CLH Employee and a Veteran

Personal Information

Education Information

Employment Experience

Anticipated Costs

Supporting Documents

Essays

Eye Report

Related Links

Scholarship Application

Personal Information

Education Information

Employment Experience

Anticipated Costs

Supporting Documents

Essays

Eye Report

Related Links

Veterans Login