CARE Scholarship Application

CARE Dallas will award up to five $1000 scholarships to deserving high school seniors who have demonstrated a commitment in their personal life to making positive choices regarding the use of alcohol and other drugs. Consideration will be given to students who have shown leadership and character and have served as role models to others by standing firm against peer pressure. The recipients should reflect the ideals and goals of CARE or other drug/alcohol prevention educational programs.

Completed applications must be submitted by 5:00 p.m. on Thursday, March 23, 2017.


Please complete the form below

Name *
Phone (Cell) *
Phone (Cell)
Address *
Father's Name
Father's Name
Father's Phone
Father's Phone
Mother's Name
Mother's Name
Mother's Phone
Mother's Phone
High School Counselor Name *
High School Counselor Name
Counselor Phone *
Counselor Phone
Personal Essay
Choose one of the following questions to answer. We suggest writing your essay in a word processor and then pasting your final essay into the appropriate form field.
Describe a time when you were aware of or experienced a situation related to drugs and alcohol. Please explain how this experience has impacted your decision about substance use. (650 words maximum)
Describe a time when you identified a drug or alcohol problem and took action to make a change. What did you do and what did you learn? (650 words maximum)
Activities & Personal History
Please list any meaningful activities you have been involved in during high school. Please list the name of the activity, the grades you were in while participating, how many hours each week you participated, and any positions you held.
Have you ever served as a leader among your peer group or in the community regarding issues with alcohol or other drugs? *
Have you ever been convicted of an offense (other than traffic violation) by a government entity? *
A response of yes does not necessarily disqualify students from scholarship funds.
Have you ever used drugs or alcohol? *
A response of yes does not necessarily disqualify students from scholarship funds.
All information in my application is complete, factually correct and honestly presented.