PLEASE RETURN TO COUNSELOR MARCH 30, 2015 Raytown-Lee's Summit Community Credit Union STUDENT SCHOLARSHIP APPLICATION FORM Name: _______________________________________________________ Please Print High School: __________________________________________________ School Choice: ________________________________________________ Major/Minor: _________________________________________________ Fathers Occupation: ___________________________________________ Mothers Occupation: __________________________________________ Are there siblings attending school currently _____ Yes _____ No If yes, give details: _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ Any family circumstance you care to note:_________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ RLSCCU STUDENT APPLICATION FORM SCHOOL ACTIVITIES: _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ COMMUNITY ACTIVITIES: _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ JOBS HELD: _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ SCHOLARSHIP What is your cumulative GPA? _________ Your SAT______ or ACT ________ How many High School credits have you earned? _____________ What is your rank in class? _________ Write a concise statement of your future plans and your need for this scholarship. _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ (Put additional information on the back of this form) ATTACH TWO LETTERS OF RECOMMENDATION. “I attest that the information supplied in this scholarship application is correct.” ____________________________ Signature of Student _________________________ Signature of Counselor ____________________________ Date _________________________ Date