Scholarship Application Form
Application Deadline - April 18, 2012
Read and follow the instructions carefully prior to submitting your application. (
Include link to instructions here
)
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All winners will be notified on or before the 30th of April 2012.
Read and Understand the instructions.
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Yes, I have
If selected, you will be asked for documentation to support the data you provide. Likewise, all correspondence and award agreements will be generated from the personal information submitted below. So, please use proper spelling, capitalization and punctuation.
I. Personal Data:
Tell us about yourself
Full Name
*
First Name
Last Name
Birthdate:
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
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1974
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1971
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1968
1967
1966
1965
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1963
1962
1961
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1950
1949
1948
1947
1946
1945
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1943
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1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Mobile No. :
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-
Area Code
Phone Number
E-mail :
*
Where the confirmation will be send to
Home Address :
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Optional Informations :
Information regarding gender, ethnic origin and race are optional. The information is requested for post-scholarship report generation only and in no way affects your selection for college scholarship awards. However, providing this information may increase your opportunities for scholarships where donors have asked that priority consideration be given to students meeting certain demographic criteria (such as minority status, parent's place of employment, area of study, etc.)
Gender:
Male
Female
Are you a US citizen?
Yes
No
Ethnic Origin:
Hispanic
Non-Hispanic
Not Indicated
Race? (Choose one or more):
White
Black or African American
Asian
American Indian or Alaskan Native Hawaiian or Other Pacific Islander
Non-Resident Alien
Please check veteran status (Check all that apply)
Veteran
Child of a Veteran
Grandchild of a Veteran
Spouse of a Veteran
None of the Above
Status at the time of application:
I will graduate in May 2012
I will be an incoming freshman graduating high school prior to 2012
I have attended college but have less than 32 college credit hours
I have attended college but have at least 32 or more college credit hours
I am a GED graduate with no college credit hours
Are you a first generation college student ?
Yes, I am the first among my parents or grandparents to attend college.
No, either my parents or grandparents have attended college.
Major Area of Study:
Please Select
Accounting (AS Degree)
Aerospace Technology (AAS Degree)
Agricultural Science (AS Degree)
Air Conditioning/Refrigeration (AAS Degree)
Applied Technology (AAS Degree)
Art (AS Degree)
Automation/Robotics (AAS Degree)
Biological Science (AS Degree)
Business (AS Degree)
Business Administration (AAS Degree)
Chemistry (AS Degree)
Child Development (AAS Degree)
Child Development (AS Degree)
Clinical Laboratory Technology (AAS Degree)
Computer Graphics (AAS Degree)
Computer Information Systems (AAS Degree)
Computer Information Systems (AS Degree)
Criminal Justice (AS Degree)
Dental Assisting (AAS Degree)
Design Drafting Technology (AAS Degree)
Electrical Technology (AAS Degree)
Elementary Teacher Education (AS Degree)
Emergency Medical Services (AAS Degree)
English (AA Degree)
Fire Services Management (AS Degree)
General Education (AS Degree)
Health & Physical Education (AS Degree)
Industrial Maintenance (AAS Degree)
Law/Pre-Law (AA Degree)
Machine Tool Technology (AAS Degree)
Mathematics (AS Degree)
Medicine/Pre-Medicine or Pre-Dentistry (AS Degree)
Medicine/Pre-Veterinary Medicine (AS Degree)
Missile and Munitions Technology (AAS Degree)
Music Education (AS Degree)
Music Industry Communications (AAS Degree)
Nursing/ADN (AAS Degree)
Nursing/Pre-Nursing (AS Degree)
Paramedic (AAS Degree)
Pharmacy/Pre-Pharmacy (AS Degree)
Photography and Film Communications (AS Degree)
Physical Therapist Assistant (AAS Degree)
Pre-Engineering (AS Degree)
Process Technology (AAS Degree)
Renewable Energy
Secondary Teacher Education (AS Degree)
Theater Arts (AS Degree)
Undecided
Please indicate what is your major are of study
What is your Career Objective:
0/300
Are you interested in one of the following Fine Arts Scholarships? If yes, you will need to audition or present a portfolio to meet eligibility requirements. Please call the Fine Arts Department at (888) 888-8888 to schedule an appointment.
Fine Arts Interest:
Not Interested
Chorus
Performing Arts (Theatre)
Guitar Ensemble
Jazz Band
Graphic Art/Photo/Painting/Drawing
Have you submitted an application for admission?
Yes
No
II. High School Information:
Are you or will you be a May 2012 high school graduate?
Yes
No
May 2012 high school graduates are eligible for consideration for summer scholarships in addition to fall-spring awards. Accepting a summer award obligates you to attend in the following fall and spring.
Would you like to be considered for a summer award?
Yes
No
High School Attended:
Please Select
Ardmore High School
Athens Bible School
Athens High School
Austin High School
Bob Jones High School
Buckhorn High School
Butler High School
Catholic High School
Clements High School
Columbia High School
Covenant Christian Academy
Decatur Heritage Christian Academy
Decatur High School
East Lawrence High School
East Limestone High School
Elkmont High School
Faith Christian Academy
Grissom High School
Hartselle High School
Hazel Green High School
Huntsville Center for Technology
Huntsville High School
Johnson High School
Lee High School
Limestone County Career and Technical High School
Madison Academy
Madison County Career and Technical Center
Madison County High School
New Century Technology
New Hope High School
Oakwood Academy
Priceville High School
Randolph High School
Seldon Educational Progress Center
Sparkman High School
Speake High School
Tanner High School
Valley Fellow Christian Academy
West Limestone High School
West Morgan High School
Westminster Christian Academy
Other
Year of High School Graduation or GED:
Most recent cumulative GPA:
High School activities, community activities, volunteer work, honors, offices held:
III. ACT Information:
Year you took the ACT:
ACT composite (overall) score?
ACT scores are not required for scholarship eligibility. However, providing an ACT score can increase the likelihood of your selection as compared to other candidates.
All scholarship applicants reporting an ACT score will be asked to provide official verification.
Note: If you are a 2012 high school graduate and received a composite score of 26 or higher you are eligible for an automatic one-year full tuition scholarship.
IV. For Transfer Students Only:
Most recent college attended and cumulative transfer GPA:
V. For Students Currently Enrolled at (School Name) :
Approximate credit hours completed by May 2012:
Current GPA:
School activities, honors, offices held, etc.:
VI. Extras:
(School Name) administers many scholarships designed to offer aid to students that represent unique characteristics. Please check each of the qualifiers below that apply to you. This data may increase your likelihood of qualifying for selected scholarships. Please note, if you are awarded a scholarship based on any of these qualifiers, you will be asked to produce documentation verifying your unique eligibility.
Have you ever received a scholarship at (School Name)?
Yes
No
Do you plan to complete your two-year degree with (School Name)?
Yes
No
Do you plan to transfer to another college and complete a 4-year degree?
Yes
No
Are you an Eagle Scout?
Yes
No
Do you have a disability?
Yes
No
Are you a GED recipient?
Yes
No
Do you reside (or have you ever resided) at Morgan County's Boy's or Girl's ranch?
Yes
No
Are you a graduate of Horizon High School in Decatur, Alabama?
Yes
No
Are you interested and willing to major in Aerospace Technology?
Yes
No
Are you interested and willing to major in Science, Technology, Engineering (Pre-Engingeering) or Math?
Yes
No
Are you a member of Vestavia Hills Church?
Yes
No
Are you a member of First Baptist Church of Decatur?
Yes
No
Were you born outside the USA?
Yes
No
If so, what country?
Were your parents born outside the USA?
Yes
No
If so, what country?
In addition to a scholarship, would you like to be considered for co-op opportunities (working part-time for tuition support with company relevant to your major)?
Yes
No
Will you be working while attending (School Name)?
*
Yes
No
If so, will you work:
Full-time
Part-time
Please check if you or any of your family work for any of the following organizations:
Cooks Pest Control
RBC
3M
Bunge
BP
Do you have a relationship with anyone affiliated with Trinity High School?
Yes
No
If yes, Name and Year of their graduation:
VII. Essay
Your essay should be 300-500 words. You should address in your essay: your college goals and choice of major, what you intend to do with your education, and why a scholarship is important to you. Include any academic and non-academic accomplishments, personal characteristics, or experiences that make you uniquely worthy of scholarship consideration.
Essay:
0/500
VIII. Applicant's E-Signature
By signing (typing your legal name) in the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.
E-Signature:
*
Submit Form
Print Form
(School Name)
is committed to equal opportunity in employment and education. The College does not discriminate in any program or activity on the basis of race, color, religion, gender, age, national origin, disability, marital status, or any other protected class.
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