Women Leaders in Action Scholarship Application Form

To be considered for this scholarship, you must be a senior high school student residing in New Jersey, intending to pursue a degree in the Healthcare field, Liberal Arts, or Science Technology Engineering Math (S.T.E.M.). This application is free of charge.  If you have any questions, email: info@empowerwomenforsuccess.org

Complete the form below to participate in this scholarship!


Submit your application and all required documentation by
Friday, May 27, 2022 at 11:59 PM EST

Please submit your resume, essay, school transcript, and application all together via email. Your essay should be 300-500 words. You should address in your essay: your college goals and choice of major, what you intend to do with your education, and why a scholarship is important to you. Include any academic and non-academic accomplishments, personal characteristics, or experiences that make you uniquely worthy of scholarship consideration.

By submitting this application, you are certifying that all information is correct and that you are the person completing this application. W. L. A. reserves the right to keep any information submitted.

Provide two referee names with full contact details. (One must be a school referee such as a counselor, teacher or professor).

Personal Details
First Name *
Last Name *
Mailing Address
Address Line 1 *
Address Line 2
City *
State/Province *
Postal Code *
Current Study Status & Intentions
Current Academic Status
No file selected
You Intend to Study
First Name *
Last Name *
First Name *
Last Name *
Supporting Documents - Resume and Essay
No file selected
Women Leaders in Action logo.


WLA knows that college is a big step forward in achieving your goals and we are here to help get you there.