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Youth Empowerment Scholarship Program!!!

Application for Students in Grades 9–12

The FATHERS M.I.A. Youth Empowerment Program was birthed from the vision of our founders, Gernald Hawkins, Sr. and Robert L. Jackson III, to create meaningful connections between young people experiencing fatherlessness and a community that cares about their future.

The program is designed to mentor, encourage, empower, and support students who are growing up without an active father in their lives. Through mentorship, youth empowerment sessions, community engagement, and meaningful experiences, we strive to help bridge the gap between children and their fathers while encouraging fathers along their own journey from Missing In Action to becoming Motivated, Involved & Active.

As We Honor You Spring Gala

Through this application, FATHERS M.I.A. will select a minimum of 30 deserving high school students in Grades 9–12 from Broward and Miami-Dade Counties to participate in our “As We Honor You” Spring Gala.

This special evening will focus on young ladies who do not have an active father in their lives. To be considered for the program and Gala, the applicant’s father must not be actively involved in her life.

The Gala is designed to provide an unforgettable experience that celebrates, honors, and encourages these young women while reminding them that their circumstances do not define their future.

We are proud to partner with local law enforcement agencies, whose outstanding first responders will accompany and support our honorees throughout the evening. Their presence will provide encouragement, mentorship, and a visible demonstration of the community standing alongside these young women on such a special night.

Scholarship Opportunity & Program Requirements

Scholarship recipients will be announced during the “As We Honor You” Spring Gala on Saturday, April 3, 2027. Scholarship recipients must be present at the Gala to be awarded their scholarship.

Students applying for scholarship consideration must meet the following requirements:

Submit a completed application with all required information.
Submit a minimum 300-word essay addressing the effects of fatherlessness and explaining how receiving a scholarship would support the student’s future goals.
Attend the required weekly Youth Empowerment Sessions on Monday evenings. Approximately eight sessions are required for eligibility for scholarship consideration.
Remain actively engaged and participate in the program throughout the required sessions.

Please read all instructions and requirements carefully before completing and submitting your application.

We are honored to have the opportunity to walk alongside these young people, celebrate their accomplishments, and invest in their future. Thank you for allowing FATHERS M.I.A. to be a part of your journey.

We look forward to receiving your application and celebrating you!

Name *

First

Last

Address *

City *

State *

Zip *

(Cell) Phone Number *

Home Phone Number

Participant’s Email *

Email

Confirm Email

Date of Birth *

Age *

Gender *

Male
Female

Ethnicity (copy) *

Native American or American Indian
Hispanic or Latino
Black or African American
White
Asian / Pacific Islander
Other

High School *

Grade *

GPA *

Prospective Colleges *

Intended Major/Concentration

Father / Family Information

Which BEST describes your biological or legal father? *

Deceased
Unknown
Incarcerated
Estranged
Known but not active in my life
Occasionally involved, but not consistently
Actively and consistently involved in my life
Other________________________________________

Does your father currently live with you? *

Yes
No
Sometimes

How often do you communicate with / spend meaningful time with your father? *

Regularly
Occasionally
Rarely
Never
Not Applicable

Please briefly describe your current relationship with your father. *

Who do you currently live with? *

Mother
Father
Stepparent
Grandparent(s)
Relative
Guardian
Other_____________________

If possible, would you be willing to restoring your relationship with your father? *

Parent / Guardian Information

Parent / Guardian Name *

First

Last

Cell Phone # *

Work #

Email *

Honors/Awards/Achievements

All About You!

Are you currently employed? *

Yes
No

Extracurricular Activities

Activities (includes clubs and sports) *

Honors/Awards/Achievements *

Tell us a little about yourself (Family, friends, school, any special interest, community involvement, hobbies)

Describe a powerful moment that you remember about your father?

Essay for Seniors ONLY

Please describe the impact that fatherlessness has impacted your life and how this scholarship will benefit your future academic goals. Your essay should be a minimum of 300 words.

(This is required for all Seniors! Type N/A if you are not a Senior).

Additional Information

How did you hear about us?

Proof of acceptance or current enrollment is required prior to funds being released to the college or university

Student & Parent/Guardian Acknowledgment

Please Read Before Checking & Signing *

I/We certify that the information provided in this application is true and complete to the best of my/our knowledge.
I/We understand that Fathers M.I.A. serves high school students experiencing fatherlessness and may request additional information or clarification as needed to determine program eligibility.
I/We understand that providing false or intentionally misleading information may result in disqualification from the program, scholarship consideration, and/or rescission of a scholarship award.
I/We understand that being notified or publicly announced as a scholarship recipient does not constitute a final scholarship award or disbursement of funds. If false or intentionally misleading information affecting eligibility is discovered before scholarship funds are disbursed, the scholarship may be withdrawn and will not be awarded.
I/We understand that participation in the Fathers M.I.A. Empowerment Program does not guarantee a scholarship.
I/We understand that weekly attendance at the Youth Empowerment Sessions held every Monday for approximately 8 weeks, is a requirement for continued program participation and eligibility for scholarship consideration.
I/We understand that scholarship recipients will be announced during the Fathers M.I.A. Gala on Saturday, April 3, 2027. I/We understand that scholarship recipients must be present at the Gala to be officially awarded their scholarship.
I/We understand that all graduating seniors who wish to be considered for a scholarship must complete and submit a minimum 300-word essay as part of the scholarship requirements.

Acknowledgements and Signatures

Candidate

My signature below confirms that I have provided complete information in this application and that I understand that I may be contacted if there are questions or concerns about my application package.

Printed Name (Represents Signature) *

Date *

Parent/Guardian Information

Parent/Guardian — Required for Students Under 18 *

If my child is selected, I give my permission for my child to participate in the “As We Honor You” Fathers M.I.A. Youth Empowerment Scholarship & Spring Gala Program, presented by Fathers M.I.A.

Contact Number *

Print Name Again For Parent/Guardian’s Signature *

Date *

Image Release Form

I grant to Fathers M.I.A. and their representatives (hereinafter “Sponsors”) the right to take photographs, videos, or other visual media of me and my property relating to the “All About You”Youth Empowerment Scholarship Program, , including any culminating events. I authorize Fathers M.I.A. and Sponsors to copyright, use and publish the same in print and/or electronically. .

I agree that Fathers M.I.A. and Sponsors may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and web content.

I have read and understand the above.

Applicant's Name *

Parent/Guardian — Required for Students Under 18 (copy) *

If my child is selected, I give my permission for my child to participate in the “As We Honor You” Fathers M.I.A. Youth Empowerment Scholarship & Spring Gala Program, presented by Fathers M.I.A.

We are moving fathers that are missing in action to motivated involved and active. Our organization believes that a house without a father is in a condemned state.

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Contact

Contact Info

Address: Broward County: 3600 S. State Rd. 7 Ste. 224 Miramar, FL. 33023 Phone: +1 (954) 338-4295

Dade County: 12700 Biscayne Blvd. Ste. 401 North Miami, FL. 33181 Phone: +1 (954) 559-4295

Email:admoffice@fathersmia.org

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