Foundation Scholarship

General Information

Full Name

Email Address

Canoochee Member #

High School

Telephone #

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Mother's Name

Mother's Phone #

Father's Name

Father's Phone #

Financial Need

This information will be kept strictly confidential.

Parents’ Annual Income

$0-24,999

$25,000-49,999

$50,000-74,999

$75,000-$99,999

$100,000-125,000

Other…

Total number of dependents in your family/household

Include yourself & parents too.

Dependents’ Ages

Number currently attending a college or technical school

Father’s Occupation & Employer

Mother’s Occupation & Employer

Explain your need for this scholarship

Other scholarships, grants or financial awards that you have received or expect to receive

Academic Ability

Weighted Grade Point Average

Non-Weighted Grade Point Average

Copy of your current high school transcript

Upload requirements

Verbal SAT Score

Math SAT Score

Writing SAT Score

Total SAT Score

Highest Composite Score from ACT

Proof of Scores

Upload requirements

High School Scholastic Awards and Honors

Other Activities

List the following for high school years only.

Membership in school organizations; indicate which years and include any offices you held

Other high school activities (sports, etc.)

Are you currently employed?

Yes

No

Work Title

How many hours a week?

How long have you had this job?

Have you had other work experience?

Yes

No

What type of work and when?

Interview Questions

Please answer the following questions to the best of your ability.

What are your strengths?

What are your weaknesses?

What adjectives would you use to describe yourself?

What past accomplishments gave you satisfaction?

Where do you see yourself in 20 years?

Explain how you overcame any hardships in your family over the past four years.

Affirmation

AFFIRMATION: All information provided on this application and accompanying attachments is complete and accurate to the best of my knowledge.

Applicant Signature

Sign above

Date & Time

Parent/Guardian Signature

Sign above

Date & Time

CAPTCHA

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OUTAGES/CONTACT: 800-342-0134