Cottey College Scholarship 1st year student

P.E.O. Scholarship Application Nevada State Chapter

Application for First Year Students
Please verify that you are human*
Note: Prior to filling out this application, a recommendation from a Nevada P.E.O. Chapter member is required. Please contact the Cottey College Scholarship Chair at ptognoli@gmail.com as soon as possible if you need assistance connecting with a Nevada State P.E.O. member or if you have other questions.
Last Name:*
Last Name
First: *
First Name
Middle:
Middle
Preferred:
Preferred
Address:*
Address Line: 2
City:*
City
State:*
State
Zipcode:*
Zipcode
Primary Phone:*
Secondary Phone:
Email:*
example@example.com
I authorize the Nevada State Cottey College Committee to share my contact information with Nevada P.E.O. chapters.*

YesNo
I am a United States Citizen:

YesNo
Last four digits of social security number - (Enter 0000 if none):*
Date of Birth:*

MonthDayYear
Date of acceptance to Cottey College:*

MonthDayYear

Note: Prior to filling out this application, a recommendation from a Nevada P.E.O. Chapter member is required. Please contact the Cottey College Scholarship Chair at ptognoli@gmail.com as soon as possible if you need assistance connecting with a Nevada State P.E.O. member or if you have other questions.
Have you had any contact with a local P.E.O. chapter or member?*

YesNo
*

Family Information
Parent #1 Name:*
Parent #1 Occupation:*
Parent #1 Address:*
Parent #1 City, State, Zip*
Parent #2 Name:
Parent #2 Occupation:
Parent #2 Address:
Parent #2 City, State, Zip
Number of Siblings at home:*
Number of family members in college (Including yourself and parents):*
Special Circumstances (for example, medical, family, financial need, etc):*

High School Information
Name of High School Attended:*
City:*
Year Graduated:*
Cumulative GPA:*
Class Rank:*
# of students in graduating class:*
ACT or SAT

Please give ACT or SAT score:
Score*
Which test score did you provide?*

ACTSAT
List High School activities including work experience, # of years participation and special awards/honors:*
List High School activities including work experience, # of years participation and special awards/honors: *
List High School activities including work experience, # of years participation and special awards/honors:*
Other special awards or recognitions:
What are your educational/career goals at this time?*
APPLICANT VERIFICATION STATEMENT:

I verify all statements in this application are factually correct and honestly presented. I understand that failure to provide true and complete information could mean withdrawal of scholarship monies.
Applicant Signature:*

Clear
Date Signed by Applicant:*

MonthDayYear
Date
Application due date: February 1, 2023

CONFIDENTIAL FINANCIAL STATEMENT
To be completed jointly by the applicant and parent:
Name of Applicant:*
Parent #1 Name*
Parent #1 Occupation*
Parent #1 Employer*
Parent #2 Name
Parent #2 Occupation
Parent #2 Employer
Combined yearly gross income:*
List all children (including yourself) in family and their age:
Applicant's work experience:
Applicant's Current employment:
Other scholarships or financial aid applied for and amounts. Click + to add more rows. If none, type none and 0 for dollar amount:*
PARENT/GUARDIAN VERIFICATION STATEMENT:

I certify that all financial statements above are factually correct and honestly presented.
Parent's/Guardian's Signature:*

Clear
Printed Name:*

First NameLast Name
Date Signed by Parent/Guardian:*

MonthDayYear
Date
Application due date: February 1, 2023

Letter of enrollment from Cottey College
Upload your enrollment letter now*

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Official High School Transcript
Upload an official copy of your high school transcript now*

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Three Letters of Recommendation
Upload a Letter of Recommendation from applicant’s sponsoring Nevada State P.E.O. member. A scan of the original emailed letter is acceptable. However, If you are unable to scan or pdf an emailed recommendation letter, you may forward the letter to ptognoli@gmail.com.*

Accepted file formats are .jpg, .doc and .pdf.
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Upload a letter of recommendation from a high school guidance counselor, a teacher, family friend, or a previous or current employer. Scans acceptable.*

Accepted file formats are .jpg, .doc and .pdf.
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Upload an additional letter of recommendation from a different high school guidance counselor, a teacher, family friend, or a previous or current employer. Scans acceptable.*

Accepted file formats are .jpg, .doc and .pdf.
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Personal Statement
Upload a brief autobiography addressing your reasons for wanting to attend Cottey College, what you hope to gain from the experience, or tell something unique or special about yourself. *

Accepted file formats are .doc and .pdf.
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Official Copy of ACT or SAT Scores
Upload an official copy of ACT or SAT scores now*

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Proof your form to be sure that all required fields have been filled in and that all errors have been corrected. Then check that all of the below requirements have been met: If any of these items are missing, the form will not submit. A successful submission will generate an immediate Thank you message and an email confirmation showing all of your entered responses. If you do not receive such a confirmation and have checked your junk folder, you will need to proof the form again before submitting.
Checklist for Applicant.*

1. Verification of enrollment at Cottey College2. Submit an official high school transcript.3. Submit one Letter of Recommendation from applicant's sponsoring Nevada State P.E.O. member. Scans of the original emailed letters are acceptable. However, if you are unable to scan or pdf an emailed recommendation letter, you may forward the letter to ptognoli@gmail.com4. Submit one Letter of Recommendation from a high school guidance counselor, a teacher, family friend, or a previous or current employer. Scans acceptable.5. Submit one Letter of Recommendation from another high school guidance counselor, teacher, family friend, or a previous or current employer. Scans acceptable.6. Submit a brief autobiography addressing your reasons for wanting to attend Cottey College, what you hope to gain from the experience, or tell something unique or special about yourself.7. Submit an official copy of your SAT or ACT scores.8. Complete a confidential financial statement.9. Submit this application and the required supporting information online. If you have encountered any problems with this application, please contact the Nevada State Cottey College Scholarship chair at ptognoli@gmail.com in time to meet February 1st deadline.

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