Bettendorf Americana Student Scholarship Application

First name

Last name

Birthday

Month

Day

Year

Address

Phone

Current School Name

Grade level or year in school

Cumulative GPA (If applicable)

Intended field of study (School or trade)

Amount of financial support needed

What are your educational and career goals?

How will receiving this scholarship help you achieve your goals?

Tell us about a challenge you’ve overcome and how it has shaped who you are.

Letter of Recommendation (from a teacher, mentor, or community leader)

I certify that all the information provided is true and complete to the best of my knowledge. I give permission to Rust Belt Americana to contact my school or references as needed.

Signature of applicant

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Signature of parent/guardian if applicant is under the age of 18

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RUST BELT AMERICANA

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August 6-8, 2026 | East moline, IL

Bettendorf Americana Student Scholarship Application