Home > K.C. Sinclair Scholarship > Scholarship Application

The K.C. Sinclair Scholarship  

www.my-cccu.com

 

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