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Scholarship Application

We're proud to support the next generation of students who have given their time to the Ronald McDonald House of Siouxland mission. If you've volunteered with us, we encourage you to apply.

Complete the form below and attach your certified grades and personal statement.

Questions? Reach out to us at info@rmhc-siouxland.org

This field is for validation purposes and should be left unchanged.

Name(Required)

First Middle Initial Last

Date of Birth(Required)

Gender(Required)

Female

Male

Non-binary

Home Phone(Required)

Cell Phone(Required)

Email(Required)

Permanent Mailing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

RACE/ETHNICITY(Optional)

Please check the appropriate box if you choose to complete this section (used for statistical purposes only).

American Indian or Alaska Native

Asian

Black or African American

Hispanic or Latino

Native Hawaiian or Other Pacific Islander

White

Other: Specify

If other, please specify

ACADEMIC INFORMATION

Name of Current School

Name of School Attending in Fall 2026

Major/Field of Study

High School

Year of Graduation

Anticipated College Graduation Year

Have you volunteered at RMHC of Siouxland?(Required)

Yes

Date of volunteer service: Month/Day/Year(Required)

How many hours did you volunteer at RMHC of Siouxland?(Required)

Please list other non-RMHC volunteer service

Has your family stayed at RMHC of Siouxland?(Required)

Yes

Date of Stay

Family Information

Father's Name

First Last

Mother's Name

First Last

Contact Name for Parent/Legal Guardian

First Last

Parent/Legal Guardian Phone Number

Relation to Applicant

Please attach the applicant’s certified grades. Must include cumulative GPA and courses taken.

Max. file size: 256 MB.

Please attach a personal statement from the applicant, no more than 500-1000 words, that answers the following question: How has your family come together to overcome a challenge?

Max. file size: 256 MB.

CERTIFICATION AND AUTHORIZATION

This online form requires a digital signature to be complete. All the information provided on this application and in the enclosed documents is true and complete to the best of my knowledge. I certify that I am currently enrolled and in good standing at a post-secondary educational institution and am eligible to receive scholarships granted under the RMHC Program. I hereby authorize RMHC to use any information contained in this application for the purpose of promoting and publishing the program or as legally required or permitted.

AUTHORIZATION FOR RELEASE OF RECORDS

To comply with the provisions of the Family Educational Rights and Privacy Act of 1974, permission is hereby given to school officials to release school records and other requested information for consideration in the RMHC Scholarship Program.

Digital Signature(Required)

Today's Date

Parent or Guardian’s Signature (required if applicant is under 18 years of age):

Location:
2500 Nebraska Street
Sioux City, IA 51104

712.255.4084

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© RMHC 2026. The following trademarks used herein are owned by McDonald’s Corporation and its affiliates; McDonald’s, Ronald McDonald House Charities, Ronald McDonald House Charities Logo, RMHC, Ronald McDonald House, Ronald McDonald Family Room, and Ronald McDonald Care Mobile. RMHC is recognized as a public charity under Internal Revenue Code section 509(a) and has 501(c)(3) status. Donations to RMHC are deductible. Donors should consult their tax advisor for questions regarding deductibility. The RMHC of Siouxland EIN is 42-1369988. A copy of the RMHC determination letter is available upon request.