Entry Form
Resident Scholarship Program Details

Awards are $6,000 each and are issued to your educational institution before the 2021 fall academic term. A total of 20 scholarships will be awarded. Scholarships may be awarded to past recipients of the scholarship program. Past recipients may submit an application up to five (5) days before the start of the scholarship entry period. Prior recipients who enter and fulfill all requirements shall be awarded preference over new applicants, and remaining scholarships shall be awarded to new applicants after such preference is given.

On or about Monday, May 3, 2021, the scholarship drawing will be held. Potential recipients will be asked to provide additional information, such as proof of enrollment form, W-9 form, and a photo. You will become an official scholarship recipient only after that information is received. Once received, a check will then be sent to your school for the fall 2021 academic term. A maximum of three alternate drawings will be conducted, after which any or all unclaimed scholarships will remain un-awarded. On or about Friday, July 9, 2021, all applicants will be notified whether they have been awarded a scholarship. 

Scholarship payments are made directly to your college, university, or technical school by Housing Authority Insurance, Inc., and are deposited into an F.B.O. (For Benefit Of) account. The scholarship is available for you to use towards your fall 2021 tuition, school supplies, and book expenses as necessary. If there are funds remaining after the fall 2021 semester, the scholarship is available for you to use during the remaining 2021-2022 academic year (winter 2022, spring 2022, and summer 2022 semesters; if applicable), and it is the responsibility of the school to hold these funds in the F.B.O. account for you and apply them. Any funds remaining after the 2021-2022 academic year must be returned to Housing Authority Insurance, Inc. by the school no later than September 1, 2022.

Should you have questions or need more information, please email us at scholarship@housingcenter.com.
Section One

Before completing section two, make sure you review and sign off that you reviewed the below information. Incomplete entries will not be considered, and you will not be contacted if your entry form is incomplete.

I have:
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3. Read the frequently asked questions. Access FAQs here.
Please indicate yes or no that you read the items above:*
Section Two
Download each of the forms below before moving on to section three.

Forms to Download:
1. 2021 Affidavit –
Download form here

*Read: This form must be filled out and signed by ALL applicants. In the event that the applicant is under 18 years of age, the applicant’s guardian must complete the form on the applicant's behalf. If you cannot electronically sign this document, please print it out, sign it, and then scan/upload the completed form.

2. 2021 Proof of Residency Form
Download form here
*Read: This form must be signed by the housing agency or landlord. Please instruct them to print it out, sign it, and then scan/upload the completed form.

Upload Affidavit Form:*
Upload Proof of Residency Form:*
Note: To be eligible for this scholarship, you must be a United States citizen or permanent resident (with a green card).
Section Three 
First Name*
Last Name*
Middle Name
Street Address*
Street Address Line 2
ZIP Code*
Housing Authority or Agency Name*
Is This:*
Phone Number*
Email Address*
What type of institution are you planning on entering for the fall 2021 semester?*
Number of Years Until Graduation *
Are you a U.S. Citizen?*
To which gender identity do you most identify? (optional)