Brian Caubarreaux Do It Right Scholarship Application Central Louisiana Technical Community College Application Deadline: April 27, 2015 The Brian Caubarreaux Do It Right Scholarship will provide a scholarship to a student planning to attend any CLTCC campus majoring in a Career & Technical Education Program. Priority will be given to a student with financial need. The amount awarded will occur after the last day to withdraw, and can only be used towards tuition, fees, and books. Eligibility Requirements: • • • • • • Admitted to any CLTCC campus (Alexandria, Cottonport, Ferriday, Jena, Leesville, Oakdale, Winnfield) o To apply, go to www.CLTCC.edu and click on Apply for Admission. The application is free. Majoring in a Career & Technical Education Program Minimum 2.5 GPA, 45 High School Equivalency Test (HiSET) or 450 GED score Completed FAFSA (Free Application for Federal Student Aid - financial aid form) on file at CLTCC U.S. Citizen Finalists are required to attend an in-person interview at CLTCC with the scholarship committee Hand deliver, mail, fax or e-mail completed application to: Central Louisiana Technical Community College Attn: Heather Poole, Vice Chancellor for Student Affairs 4311 S. MacArthur Dr. Alexandria, La 71302 Phone: 318.487.5443 ext. 1160 Fax: 318.487.5970 [email protected] Application Deadline: April 27, 2015 I. Personal Information (Please type or print) Name: ________________________________ LAST FIRST MI Email address: _________________________ Address: ______________________________ Date of Birth: __________________________ ______________________________ Parish: _______________________________ CITY STATE ZIP Cell: ( ) _____- _________ Major/Career: _________________ Home Phone: ( ) _____- __________ CLTCC Campus you plan to attend: _________ II. Academic Background High School: ___________________________ High School Graduation Year: _________ High school GPA __________ HiSET / GED score __________ or III. Short Answer Questions (You may use additional paper): 1. Briefly explain your academic/college and career goals and how you plan to achieve these objectives. ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ 2. Briefly explain your financial situation and how this scholarship will assist you and your family. ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ 3. What community activities have you been involved in? ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ 4. Briefly list your previous work experience. (Jobs, duties, number of hours, dates of employment.) ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ 5. Please tell us anything else you think we should know about you. ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ 6. Please include two letters of reference from non-family members. IV. Financial Information Family Yearly Income: _____________ Number of people living in your household: _______ Please certify that all information is true and correct to the best of your knowledge. Signing also grants permission to CLTCC to use the student’s name in any promotional material regarding the scholarship and to notify the donor of the scholarship recipient as well as academic progress at CLTCC. Only awardees will be contacted via e-mail. _______________________________________ Signature _____________________ Date