Scholarship Application Temp

Applicant Information

JSCC Student ID Number (required)

Name (required)

Gender
—Please choose an option—MaleFemale

Ethnicity
Hispanic/LatinoNot Hispanic/Latino

Race
—Please choose an option—WhiteBlack or African-AmericanAmerican Indian/Alaska NativeAsianNative Hawaiian/Pacific IslanderTwo or More RacesOther

Email Address (required)

Address (required)

Primary Telephone Number (required)

Secondary Telephone Number

Do you claim to be a legal resident of North Carolina?
YesNo

County of Residence

Are you a U.S. Citizen?
YesNo

Enrollment and Program Details

Please select your marital status
SingleMarriedSeparatedDivorced

Do you live with your parents?
YesNo

Enrollment Status (select all that apply)
First-Year StudentSecond-Year StudentFull-Time StudentPart-Time Student

Planned Program of Study (required)

Have you applied for financial assistance through FAFSA?
YesNo

What forms of Financial Aid have you been offered so far? (select all that apply)
Pell GrantWIOAStudent LoansVA BenefitsOther Financial Aid

Please explain why you have a financial need for this scholarship (required)

Educational Background

Please select your current educational status
Currently enrolled in high schoolReceived high school diplomaReceived adult high school diploma or GEDReceived a post-secondary degreeCompleted some post-secondary courses but no degree

Name of High School (required)

City & State

Date of high school graduation (MM/DD/YYYY) (required)

If you are a current high school student, will you have completed at least 3 JSCC courses by Spring 2024?
YesNo

Achievements & Experiences

Educational Activities

Volunteering & Community Service

Awards & Recognition

Work Experience

Why are you interested in the degree pathway you have chosen to pursue at JSCC? (required)

Future Educational Goals/Plans (required)

Is there any additional information you'd like to provide? (required)

Personal Essay (required)

References

Reference #1 Name (required)

Reference #1 Address

Reference #1 Telephone Number (required)

Reference #1 Email Address (required)

Reference #1 Relationship to You (required)

Reference #2 Name (required)

Reference #2 Address

Reference #2 Telephone Number (required)

Reference #2 Email Address (required)

Reference #2 Relationship to You (required)