Veralyn Jennex Memorial Scholarship Application

Applicant Information

JSCC Student ID

First and Last Name

Address

Home Phone

Work Phone

Email Address

Date of Birth

Additional Information

Number of Children in Your Family

Marital Status
SingleMarriedSeparatedDivorced

Are you a US Citizen or DACA?
YesNo

Are you a first-generation college student?
YesNo

Do you work?
YesNo

Have you applied for Financial Assistance (FAFSA)?
YesNo

Do you have a financial need for this scholarship?
YesNo

Do you have a GPA of 3.0 or higher?
YesNo

What campus groups or activities have you participated in?

Have you previously, or are you currently, doing community/volunteer service?
YesNo

If yes, what type of service?

Write a 1000-word essay on why you have chosen to seek a career in mental health, education, or nursing (required)

Provide any additional information that you feel the selection committee should know about you for this scholarship.

Are you planning to graduate in May 2026 from JSCC?
YesNo

Are you transferring to a 4-year program to pursue a degree focusing on mental health, education, or nursing?
YesNo

References

Reference Name #1

Reference Phone #1

Reference Name #2

Reference Phone #2