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Dinwiddie Chamber of Commerce
www.dinwiddiechamber.org
Scholarship Program – Application for Award
Applicants Name: ____________________________________________________________
First
Middle
Last
Street Address: __________________________________ City and State:­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­_________________________
Contact Telephone Number: (
) __________________ Alternative Number (
) ___________________
Parent’s Name:_______________________________________________________________
Employer: _______________________________
Department:_______________________
College/University you will attend: ________________________________________________
Desired area of study:____________________________________________________________
GPA:______________________________ Class Ranking: _____________________________
Items to be included in application:
1. Essay of no more than 1000 words describing your academic performance, leadership skills, community involvement, college
plans, career intentions, and the reason the committee should consider you for the scholarship. Include any honors / awards /
recognition you have received plus school and / or civic organization affiliations that may be relevant.
2.
Essay of no more than 1000 words describing how you believe the Dinwiddie Chamber of Commerce will affect your future
career.
3.
Open to Dinwiddie County High School Seniors:
Current high school transcript or report card (including GPA)
SAT or ACT test scores
Position in Class (%, ranking, and # in class)
Copy of acceptance letter to an accredited college or university
Preferred College and/ or University and field of study
One letter of recommendation based on achievement of academic standards
One letter of recommendation based on personal character standards
I hereby make formal application for the Dinwiddie Chamber of Commerce Scholarship Award. I certify that all statements contain
herein and information provided is complete and accurate.
Date
Applicant Signature
Please ensure all requested information is included in the application packet. Incomplete packets will not be considered. All
applications must be returned to Dinwiddie Chamber of Commerce, Attention Scholarship Committee, PO BOX 373, Dinwiddie,
VA 23841­0373 by THURSDAY APRIL 2, 2015 at 5p.m. EST (UPDATE: extension deadline is now 4/30/2015) to be
considered. No late applications will be accepted. Dinwiddie Chamber of Commerce is not responsible or liable for lost or late
applications. All applications are opened solely by an independent panel.
Three (3) $500 awards will be given to the Class of 2015.