Sample TCA Scholarship Application 2014-2015 Questions marked with * are required. Full Legal Name* E-mail Address* Current Address: Mailing Address* Current Telephone* Permanent Address: Mailing Address* Permanent Telephone* Personal Information: 1. Social Security Number* 2. Applicant Headshot* Upload a print-compatible (300 dpi) headshot labeled with your full name. Click here to see an example. 3. Birth Date & Place  Date of Birth*  Place of Birth* 4. What is your connection to the trucking industry?  Trucking Company*  Family Member Name*  Family Member’s Relationship to You*  Company President/CEO*  Address* 5. Please explain, in no more than 300 words, how you or your family member’s career in the trucking industry has influenced your family life.* 6. Personal Statement Clip: Judging for TCA Scholarships is based, in part, on support for the trucking industry. If you would like to provide a brief personal statement about why the industry is important to you, please upload a video or audio clip that is no longer than one minute. School & Education Information: Class in the Fall:*  Freshman  Sophomore  Junior  Senior Current GPA* Current Major* Upcoming Semester’s Course Schedule* List academic honors you have received and honorary scholastic societies to which you have been elected.* 12. List scholarships, fellowships, and/or prizes you have received during your school career.* 7. 8. 9. 10. 11. Sample TCA Scholarship Application 2014-2015 13. List and identify the extracurricular activities in which you have participated and the clubs and organizations of which you have been a member, indicating any offices held.* 14. Financial Information:  What is the tuition-only amount that will be due for the next academic year?*  What scholarships and grants will you receive toward tuition for the next academic year?*  What loans will you receive toward tuition for the next academic year?* 15. Describe briefly any independent study, research, or writing which you have completed or are now completing, including (1) where and (2) under whom completed. (Do not send copies.)* 16. Please provide the name and address of the college/university to which funds should be sent in the event that you are awarded a scholarship.  College/University*  Department*  Attention*  Address* Career & Employment Information: 17. 18. 19. 20. Please indicate what you plan to do after graduation.* Describe briefly military service, dates thereof, and present military status.* To what extent have you been self-supporting during your school career? ____% How many hours (average) did you work each week during:  The last school year?  The current school year? 21. Describe the nature of your work during your school years. 22. List in reverse order the last three full-time or part-time jobs in which you have been employed for more than six months, to include:  Employer  Address  Dates  Type of Work  Full Time/Part Time References: 23. Give as references the names of three persons, not relatives, who know your character. A faculty advisor or professor and at least one other instructor with whom you have studied should be included.  Name  Occupation  Address  E-mail  Telephone