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The K.C. Sinclair Scholarship
Complete all items, print or type responses, attach additional pages as required. (Application Must Be Received by April 1 of the Current School Year)
1. Applicant Information:
Name
Name of Parent/Guardian
Applicant’s Address
City State Zip Phone ( )
Applicant’s Social Security Number
2. Carolina Cooperative Credit Union Member Information:
Member Name
Employer Name and Work Location
Carolina Cooperative Credit Union Account Number
Relationship to Applicant
Address Phone ( )
3. School Information:
Name and Address of Current High School
City State Zip
Name and Address of Next Previous High School (if applicable)
City State Zip
4. College, University or Community College you plan to attend:
Name and Address of School
City State Zip
5. List, on a separate sheet of paper, community activities, positions held in school organizations, and any other activities or offices held that might be indicative of your leadership ability.
6. On a separate sheet of paper, provide a statement handwritten by the applicant describing future goals and aspirations.
7. Attach: School transcript(s) including 12th grade, first semester grades.
I grant permission to the K.C. Sinclair Scholarship Committee to verify all information submitted on, or in support of this application. I understand and meet all eligibility requirements. I understand that the decision of the K.C. Sinclair Scholarship Committee and the Carolina Cooperative Credit Union Board of Directors is final.
Student Signature
Parent/Guardian Signature
Revision 09/14/2005 |