Level of Educational Training, please check all that apply to you:
Name of School:
Name of School/University/College:
Names of other educational program(s) you have attended:
School of Application:
Name of Educational Institution:
Institute Telephone Number:
Date of Acceptance:
School year for which applying:
Program of Study:
Annual Tuition Costs:
Endorsement of Community Leader:
Please complete this form, print and mail it along with:
A statement of acceptance or registration from the school or university in which you are enrolled.
A statement of support from a Dom (Gypsy) community leader. (Be sure to include this person's name, address and phone number)
Dom Research Center, Inc
PO Box 121
McComb, MS 39649
You will be notified if you are selected to receive a Dom Research Center Scholarship.
Scholarships will be given directly to the educational institution (no funds will be given to individuals).
DRC scholarships are NOT full scholarships. Recipients will be notified of the exact amount of the scholarship.
Applications must be submitted by June 30 prior to the academic year for which the scholarship is requested.
Students must re-apply each year to receive a DRC Scholarship. The limitations on the number of scholarships any one applicant can receive will be determined by the scholarship administrators.
If you receive a scholarship your name, brief information about you and your studies along with a photograph will be keep on file at the Dom Research Center. This information will be used to promote the scholarship fund.