Webform for the application. Overview All students enrolled in degree seeking programs at Southern West Virginia Community and Technical College may complete this application to be considered for available scholarship programs. These programs vary in terms of qualifying criteria, award amounts and other terms. As each scholarship program has differing criteria, applicants will only be considered for those scholarships for which they qualify. All students in need of financial assistance are encouraged to apply. Instructions Please fully complete application and submit it to Southern’s Development Office. This scholarship will be kept on file for the current academic year. Incomplete applications may not be considered. Deadlines The deadline to submit this application is April 15 for Fall Semester and October 15 for Spring Semester. Applications submitted after the Priority Deadline will still be considered for any remaining scholarship funding. A completed application must be submitted for each academic year a student wishes to be considered for scholarships. Only those selected for scholarships will be notified. Name * Address * City County State - None -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Student ID Southern Email Address Date of Birth Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year1925192619271928192919301931193219331934193519361937193819391940194119421943194419451946194719481949195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015 Other Email Phone Did you graduate from High School? Yes No Name of High School G.E.D. Yes No Current GPA If first time student, please attach high school transcript. Are you presently attending Southern West Virginia Community and Technical College? Yes No Are you presently attending another college or university while enrolled and taking classes at Southern? Yes No Please provide a brief statement concerning your college plans Activities, honors, and awards Please provide a brief statement explaining your financial need Please provide a list of employment or internships including year Have you completed and submitted the Free Application for Federal Student Aid (FAFSA) for this academic year? Yes No (Southern Foundation Policy states Free Application for Federal Student Aid (FAFSA) completion is required to be eligible) In no, please submit why Please list other financial aid/scholarships you will be receiving Academic Program/Major Expected Graduation Date Please identify your first semester and year of attendance at Southern Spring 2014 Summer 2014 Fall 2014 Spring 2015 Sumer 2015 Fall 2015 I authorize Southern West Virginia Community and Technical College and the Southern West Virginia Community College Foundation, Inc. to verify all information contained in this application. Any institution, agency, or individual may release information to the College or Foundation for verification purposes. I understand the College and Foundation may release this information for verification and/or publicity purposes. It is my responsibility to inform the Development Office staff of any scholarship, grant, or waiver received by me.