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Who We Are
About Us
ADAGP Board of Directors
Foundation Board of Trustees
Staff
Contact Us
What We Do
New Coat Program
Philadelphia Auto Show
Black Tie Tailgate
Tech Comp
Photo Gallery
The Auto Industry
Industry Impact
Tech Talk
Career Opportunities
Become a Technician
Find a Dealer
Associate Members
Supporters
New Coat Program – Participating Dealerships
New Coat Program – Corporate Supporters
Golf Outing Sponsors
Tech Comp Supporters
Press
Press Releases
Coverage
More To Know
Contact
Who We Are
About Us
ADAGP Board of Directors
Foundation Board of Trustees
Staff
Contact Us
What We Do
New Coat Program
Philadelphia Auto Show
Black Tie Tailgate
Tech Comp
Photo Gallery
The Auto Industry
Industry Impact
Tech Talk
Career Opportunities
Become a Technician
Find a Dealer
Associate Members
Supporters
New Coat Program – Participating Dealerships
New Coat Program – Corporate Supporters
Golf Outing Sponsors
Tech Comp Supporters
Press
Press Releases
Coverage
More To Know
Contact
Career Portal
Fund a New Coat
Members
Pacifico Family Foundation Scholarship Awards
2023 Scholarship Recipient Information Form
Please provide information for each recipient using the form below. Remember: each scholarship must be distributed in the minimum amount of $1,750 per student.
School Name
*
Number of Recipients Chosen
*
Please enter a number from
1
to
4
.
RECIPIENT 1
Name
*
First
Last
(Middle name optional)
Email
Phone
Home Address
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Scholarship Amount
*
Please enter a number from
1750
to
7000
.
Minimum scholarship is $1,750 per student.
Plans after high school:
*
Will any family members attend the awards ceremony on May 11 at 10:00am at Pacifico Ford?
*
Yes
No
Family members are encouraged to attend!
How Many?
1
2
3
4
5
RECIPIENT 2
Name
*
First
Last
(Middle name optional)
Email
Phone
Home Address
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Scholarship Amount
*
Please enter a number from
1750
to
7000
.
Minimum scholarship is $1,750 per student.
Plans after high school:
*
Will any family members attend the awards ceremony on May 11 at 10:00am at Pacifico Ford?
*
Yes
No
How Many?
1
2
3
4
5
RECIPIENT 3
Name
*
First
Last
(Middle name optional)
Email
Phone
Home Address
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Scholarship Amount
*
Please enter a number from
1750
to
7000
.
Minimum scholarship is $1,750 per student.
Plans after high school:
*
Will any family members attend the awards ceremony on May 11 at 10:00am at Pacifico Ford?
*
Yes
No
How Many?
1
2
3
4
5
RECIPIENT 4
Name
*
First
Last
(Middle name optional)
Email
Phone
Home Address
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Scholarship Amount
*
Please enter a number from
1750
to
7000
.
Minimum scholarship is $1,750 per student.
Plans after high school:
*
Will any family members attend the awards ceremony on May 11 at 10:00am at Pacifico Ford?
*
Yes
No
How Many?
1
2
3
4
5
Guidance Counselor/School Contact Information
Name
*
First
Last
Email
*
Phone
*
Will school representative(s) attend the awards ceremony on May 11?
*
Yes
No
A school representative must be onsite to accept the check. Please remember all checks are made out directly to the respective school/scholarship fund and then each school/scholarship fund is to distribute the scholarship funds accordingly to each student.
How Many?
1
2
3
4
Name of school's local newspaper
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