Scholarship Application Deadline February 1 · High school resume Type written, biographical...
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Custer County Foundation . PO Box 304 . Broken Bow NE 68822 . 308.872.2232 . www.custercountyfoundation.org . [email protected] Scholarship Application Deadline February 1 Scholarship for which you are applying: ____________________________________________________ Name: ______________________________________________________________________________ Male:______ Female:______ Email Address:_______________________________________________ Address:________________________________ City,State,Zip:_________________________________ Date of Birth:___________________________ SSN (Last 4 Digits):_____________________________ Father/Guardian Name:___________________ Occupation:__________________________________ Mother/Guardian Name:__________________ Occupation:__________________________________ Cell Phone:___________________________ Home Phone:_________________________________ College/University you plan to attend:____________________________________________________ Anticipated Major:____________________________________________________________________ Cumulative (Overall) GPA on a 100% scale:________ Cumulative (Overall) GPA on a 4.0 scale:_______ *Include both 100% and 4.0 scores, if one is not applicable enter N/A* ACT/SAT Score:_________ Class Rank:_____ out of:______ Signature of Applicant:_________________________________________________________________ Unsigned and/or incomplete applications will not be considered. Verifying Signature of Counselor:________________________________________________________ Note: Any student whose parent or grandparent is presently serving on the Custer County Foundation selection committee will be ineligible for this scholarship. *By submitting an application, you agree that Custer County Foundation has permission to take your photograph and potentially use the photograph in promotional material to include social media.
Transcript of Scholarship Application Deadline February 1 · High school resume Type written, biographical...
Custer County Foundation . PO Box 304 . Broken Bow NE 68822 . 308.872.2232 . www.custercountyfoundation.org . [email protected]
Scholarship Application
Deadline February 1
Scholarship for which you are applying: ____________________________________________________
Name: ______________________________________________________________________________
Male:______ Female:______ Email Address:_______________________________________________
Address:________________________________ City,State,Zip:_________________________________
Date of Birth:___________________________ SSN (Last 4 Digits):_____________________________
Father/Guardian Name:___________________ Occupation:__________________________________
Mother/Guardian Name:__________________ Occupation:__________________________________
Cell Phone:___________________________ Home Phone:_________________________________
College/University you plan to attend:____________________________________________________
Anticipated Major:____________________________________________________________________
Cumulative (Overall) GPA on a 100% scale:________ Cumulative (Overall) GPA on a 4.0 scale:_______ *Include both 100% and 4.0 scores, if one is not applicable enter N/A*
ACT/SAT Score:_________ Class Rank:_____ out of:______
Signature of Applicant:_________________________________________________________________ Unsigned and/or incomplete applications will not be considered.
Verifying Signature of Counselor:________________________________________________________
Note: Any student whose parent or grandparent is presently serving on the Custer County Foundation selection committee will be ineligible for this scholarship.
*By submitting an application, you agree that Custer County Foundation has permission to take yourphotograph and potentially use the photograph in promotional material to include social media.
The following items are required:
Photocopy of high school or college transcript
High school resume Type written, biographical narrative (not a resume) about yourself, please include the following:
o Your goalso Interestso Honorso Career choiceso Extra-curricular activitieso Community and church involvemento Why you should be considered for this scholarship
Double space, 12 point font is preferred
In the event the scholarship is awarded it must be used by February 15 of the year following theaward, then it becomes null and void.
Please print and send your completed application to:
Custer County Foundation, Inc. PO Box 304
Broken Bow, NE 68822
Custer County Foundation . PO Box 304 . Broken Bow NE 68822 . 308.872.2232 . www.custercountyfoundation.org . [email protected]
