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EPCC
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Scholarships
SGA Scholarship Application
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Last Name
*
First Name
*
EPCC Student ID #
Date of Birth
Mailing Address
City
State
ZIP/Postal Code
Telephone Number
*
Alternate Telephone Number
Email Address
Gender
Resident Status
*
What is your resident status?
Major
*
Which major do you plan to declare, or currently pursue at EPCC?
Enrollment Status
*
Student Type
*
Summer Attendance
*
Will you be attending EPCC for the summer sessions?
Essay
*
Please respond to Narrative listed under Essay in the Scholarship Description.
Reception Attendance
*
A scholarship reception will be hosted during the spring/summer semester (s). Students who receive a scholarship will be contacted and requested to attend. The recipient, along with one guest of choice, will be complimentary. If you do not attend the reception, you may deemed ineligible to receive a scholarship, unless you have extenuating circumstances that will prevent you from attending.
If you receive a scholarship do you agree to attend a reception?
Photo Agreement
*
An EPCC photographer will be taking individual pictures at the scholarship reception.
Do you agree to be available before the reception for my photograph to be possibly taken?
Photo Publication Agreement
*
If your photo is taken at a scholarship related event/reception or institutional event, do you authorize publication of the picture/audio?
Testimonial Agreement
*
If you receive a scholarship do you agree to provide a testimonial during the scholarship reception or at other times deemed necessary to support the donor (s) and/or an organization if requested?
Thank You Letter Agreement
*
If you receive a scholarship, do you agree to acknowledge the donor by writing a "thank you" letter?
Correctness Certification
*
I certify that the information on this application is complete and correct and understand that the submission of false information is grounds for rejection of my application and withdrawal of offer(s)?
Information Release Permission
*
I hereby give permission for this information to be released to the donor or potential donors of any scholarship. Furthermore, I authorize the publication of any award I may receive.
Information Release Understanding
*
I understand that this authorization to release information is voluntary and will remain in effect until I revoke it in writing.
Transcript Permission
*
I grant permission for an Administrator to obtain an unofficial transcript.
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