Scholarship Application - Blowing Rock Community Foundation

Full Name*

Physical Address:*

City, State, Zip:*

Mailing Address:*

City, State, Zip:*

Cell Phone*

Home Phone

Work Phone

Email Address*

Date of Birth*

Place of Birth*

PART-TIME OR SUMMER WORK DURING THE LAST TWO YEARS:

1) Employer/Company Name*

Employer Address*

Dates of Employment*

Capacity in which employed*

Name of Supervisor*

Phone Number*

2) Employer/Company Name*

Employer Address*

Dates of Employment*

Capacity in which employed*

Name of Supervisor*

Phone Number*

COLLEGE/UNIVERSITY INFORMATION:

Choice 1*

Cost of Attendance (Tuition, Room and Board, Books and Supplies)*

Choice 2*

Cost of Attendance (Tuition, Room and Board, Books and Supplies)*

Choice 3*

Cost of Attendance (Tuition, Room and Board, Books and Supplies)*

HIGH SCHOOL INFORMATION:

High School from which you have (or will have) graduated:*

Address:*

Date of Graduation:*

SCHOLASTIC ACHIEVEMENTS:

Current High School GPA:*

(Combined SAT Scores: Verbal and Math Only)

SAT - Date Taken:*

Combined Scores:*

ACT - Date Taken:*

Combined Scores:*

Upload Test Scores:

Upload

Upload High School Transcript:

Upload

FOR COLLEGE STUDENTS ONLY:

Current GPA:*

Total Credit Hours Earned to Date:*

EXTRACURRICULAR ACTIVITIES:

Please include a statement regarding your participation in these events:*

Please list principal high school or college activities (sports, publications, art, music, student government, clubs, etc.) in order of interest to you. Elected offices should have *.

VOLUNTEER/COMMUNITY ACTIVITIES:

Please include a statement regarding your participation in these activities – especially in the Blowing Rock Community:*

Agency:*

Type of Work:*

Years Participated:*

Awards/Honors:*

ELEMENTARY SCHOOL INFORMATION:

Name of school(s) attended and dates of attendance:*

FAMILY INFORMATION:

Parent(s) or Guardian’s Full Names:*

Address:*

Parent's Current Marital Status:*

Number of Brothers/Sisters Presently Attending High School:*

Number of Brothers/Sisters Presently Attending College:*

Where?*

Receiving Financial Aid?*

Yes

Number of Brothers/Sisters Living at Home:*

INCOME & EXPENSES:

Briefly list the expenses you anticipate for the 2023-2024 academic year and the financial resources by which you expect to meet these needs:

EXPENSES:

Tuition/Fees:*

Rent, Utilities, Food:*

Books:*

Misc. (transportation, clothing, etc.):*

TOTAL EXPENSES:*

RESOURCES:

Family Contribution (According to FAFSA, if applicable):*

Student Contribution (According to FAFSA, if applicable):*

Scholarships (Received or applied for):*

Grants (Received or applied for):*

TOTAL RESOURCES:*

EXPLANATION OF NEED:

Please include a statement to describe need and any circumstances creating this need:*

REFERENCES:

Please list the names of five persons (not related) from whom recommendations may be obtained: (These persons will be called by members of the Foundation before the scholarship interview so applicant needs to notify them that their names have been listed). DO NOT LIST WATAUGA HIGH TELEPHONE NUMBERS.

1) Name:*

Relationship to You:*

Address:*

Phone (home & cell):*

2) Name:*

Relationship to You:*

Address:*

Phone (home & cell):*

3) Name:*

Relationship to You:*

Address:*

Phone (home & cell):*

4) Name:*

Relationship to You:*

Address:*

Phone (home & cell):*

5) Name:*

Relationship to You:*

Address:*

Phone (home & cell):*

BIOGRAPHICAL STATEMENT:

A typed biographical statement of at least one page expressing your desires and ambitions, reasons for continuing your academic pursuits, your need for financial assistance, and anything else you wish the committee to know about you that would be helpful in the selection process. To submit a biographical statement please upload that and a headshot below:

Upload Bio Statement:

Upload

Upload Headshot:

Upload

AUTHORIZATION:

BY TYPING MY NAME AND CLICKING SUBMIT BELOW I certify that to the best of my knowledge, the information contained in this application and its attachments are correct and complete. I agree that the Foundation has permission to verify it. THE APPLICANT WILL NOTIFY THE FOUNDATION OF ANY CHANGE IN FINANCIAL STATUS AND/OR ADDRESS.

ALL APPLICATIONS MUST BE COMPLETE AND RETURNED ONLINE HERE BY THURSDAY, APRIL 6th AT 5:00 P.M. APPLICATIONS WILL NOT BE ACCEPTED IN ANY OTHER FORMAT, AFTER THE APRIL 6th DEADLINE, AND/OR WITHOUT ALL INFORMATION  INCLUDED.

Name:*

Date:*