Raytown-Lee`s Summit Community Credit Union

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