Scholarship Application - Coastal Community Foundation

Scholarship Applying For:

Personal Information

Name*

First Name Middle Last Name

Address

Street Address Address Line 2 City State ZIP Code

Phone

Cell Phone

Email

Are you a military dependent?*

Yes
No

Are you a foster youth?*

Yes
No

Please request a letter of recommendation to accompany your application.

Name of recommender

Academic Information

Name of High School Currently Attending

Cumulative Grade Point Average (weighted / unweighted)

What is your intended college major?

What is your intended career?

First choice of college or university for fall 2019

The school must be accredited or licensed. If accepted, please include acceptance letter.

If you are waiting to be notified, to which colleges or universities have you applied?

One per line. Please include your top 3-5 choices.

Please list any financial aid, grant or scholarships you have already received for the 2019-2020 college academic year and other scholarships you have applied for this year

Name of aid/grant/scholarship	Status (Indicate received or applied)

Extra-curricular activities, community service, work experience, awards & honors

Extra-Curricular Activities

Please list any school sports or leadership experiences over the past 3 years.

Community Service Activities

Name of Organization	Dates (from/to)	Average hours per month	Activities / Positions

Please list any involvement with nonprofit, community, civic and/or faith-based organizations for the past 3 years only.

Work Experience/Internships

Name of Business	Dates (from/to)	Average hours per month	Positions / Responsibilities

Please list any internships or work experience over the past 3 years.

Honors & Awards

Please list any honors or awards you have received in the past 3 years.

Personal Statement

In the space below, please describe your personal statement

Educational & Career Goals

In the space below, please describe your educational and career goals.

I have requested a letter of recommendation for my teacher?

Yes
No

Name of Teacher

Financial

Have you completed FAFSA?

Yes
No

If so, what is your expected family contribution?

Describe Your Financial Need

Student Signature

Date

Are You At Least 18 Years Old?

Yes
No

If under Age 18, a parent or guardian’s signature is required My signature serves as permission for the Coastal Community Foundation to publish my child’s name and photos in the event he/she receives a scholarship. Furthermore, I agree to release and hold harmless the Foundation.

Parent/Guardian Information

Name

First Name Middle Last Name

Phone

Email

Parent/Guardian Signature

Date

Phone

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

Application Submission

Personal Information

Academic Information

Extra-curricular activities, community service, work experience, awards & honors

Financial

Parent/Guardian Information