Sample Student Form Page - Willoughby Western Lake County Chamber of Commerce

Student Scholarship Application

"*" indicates required fields

Name:*

First Last

Address:*

Street Address Address Line 2 City State ZIP Code

Daytime Phone Number:*

Email Address:*

Date of Birth:*

School Currently Attending:

I will be attending the following school in the upcoming semester:

Student Status:

High School Student

GED

High School Graduate

College Student

High School Graduation Date:

Course Completion Date:

Credit Hours Completed:

What specialty/major do you plan to focus on as you continue your education and what are your career objectives?

High School GPA or GED Test Score:

Current College GPA (if applicable):

ACT Score:

Year ACT test completed:

SAT Score:

Year SAT test completed:

Attachments:

Attach a one-page essay on why you are applying for the scholarship and how you will apply your skills in the future. Also attach two teacher references and high school transcript.

Drop files here or

Accepted file types: jpg, jpeg, png, pdf, Max. file size: 50 MB.

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Phone

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Student Scholarship Application