First Name (required)
Last Name (required)
Zip Code (required)
Student ID (required)
Southern Email Address (required)
Other Email Address (required)
Date of Birth (required)
Did you graduate from high school? YesNo
If yes, name of high school?
Did you earn a G.E.D.? YesNo
If first-time student, please attach high school transcript.
Are you presently attending Southern West Virginia Community and Technical College? YesNo
Are you presently attending another college or university while enrolled and taking classes at Southern? YesNo
Please provide a brief statement concerning your college plans. (required)
Please list activities, honors, and awards.
Please provide a brief statement explaining your financial need. (required)
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? (Southern Foundation Policy states Free Application for Federal Student Aid (FAFSA) completion is required to be eligible) YesNo
If no, please submit why.
Please list other financial aid/scholarships you will be receiving.
Expected Graduation Date
Please identify which semester you're applying for a scholarship. FallSpringSummer
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 Office Institutional Advancement staff of any scholarship, grant, or waiver received by me.
Email - firstname.lastname@example.orgPhone - 1.304.896.7474