Application
Blue Cross Blue Shield of South Carolina
Columbia Urban League Scholarship
2015
Deadline for submission is April 30, 2015
Criteria
This $5,000 scholarship is awarded each year to a graduating African-American high school senior who reside
in Richland, Lexington, Newberry, Fairfield, Sumter, Clarendon, Kershaw, Lee, and Allendale counties.
Applicants must:
 Have been a participant in a Columbia Urban League program.
 Have a cumulative grade point average of at least 3.00 to be eligible.
 Provide an official record of SAT and/or ACT scores.
 Provide documentation of involvement in community activities and service projects.
 Meet financial need requirement.
 Be accepted by an accredited college or university at the time of the scholarship award.
______________________________________________________________________________________________
Last Name
First Name
Middle Initial
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Street Address
City
State/Zip
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Home Telephone #
Social Security #
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Name of School
What are your career goals?
In the space provided below, discuss your plans after college as they relate to your chosen career.
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What is your anticipated major? _______________________________________________________
In the space provided below, tell us why you chose that major and what do you see yourself doing in the future.
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Education
List the school you are currently attending:
Name of School
________________________________________________________________________________
Location
________________________________________________________________________________
Dates of Attendance ________________________________________________________________________________
What is your College/University of choice? _____________________________________________________________________
Why have you chosen this particular school? ___________________________________________________________________
Activities
List any extracurricular activities and community service activities you have participated in during high
school. (Use separate paper if necessary)
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Work Experience
Please list any jobs held in the past three years. Include employer, duties and dates of employment.
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Achievement
What do you consider your most significant personal achievement?
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Goals
What personal goals have you set for yourself for the next 10 years?
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Essay
On a separate sheet of paper, type or print legibly in black ink a brief essay (200 words) using the following
theme: “The importance of academic achievement and high expectations”.
Family
(For possible news media announcements)
Father’s Name: ____________________________________________
___Living
___Deceased
Occupation: ___________________________________________________________________________
Mother’s Name: ___________________________________________
___Living
___Deceased
Occupation: ___________________________________________________________________________
How many brothers do you have? _____Older _____Younger
How many sisters do you have?
_____Older _____Younger
__________________________________________________
Signature of Applicant
_____________________
Date
Please return to:
Columbia Urban League, Inc.
1400 Barnwell Street
Columbia, SC 29201
Please submit the following:
 Official High School Transcript
 Official copy of SAT and/or ACT Test Scores
 Recent Photograph
 Household’s most recent tax return or FAFSA (a W2 form is not acceptable)
 Copy of your college or university acceptance letter
 Two letters of reference
 200 Word Essay on the topic: “The importance of academic achievement and high expectations.”
NOTE: If any of this information is missing, your application will not be reviewed.
Blue Cross Blue Shield of South Carolina
Corporate Philosophy of Educational Beliefs
Being a good corporate citizen is part of our business philosophy. At Blue Cross
Blue Shield of South Carolina, we are proud to be a strong advocate for
education. We believe that education plays a critical role in economic success
and growth, not only for the individual, but also for the community as a whole.
If we are committed to the prosperity of our state, we must all work together to
produce the best-educated citizens. In partnering with the Columbia Urban
League, Inc., we are able to further our commitment while supporting the
educational goals of youth who otherwise might not have the opportunity to
receive a college or university education.