Panola College Faculty/Staff Scholarship Application
This form is for spouses & dependent children of full-time employees only. Employees do NOT need to complete this form.
Before a Spouse or a dependent can be considered for a Faculty/Staff Scholarship, a signed copy of the most recent Tax Return must be submitted with the scholarship application for spouse and dependent verification.
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I understand
I do not understand
Semester(s) attending
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Fall
Spring
Summer I
Summer II
Student Name
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First Name
Last Name
Student ID
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Date of Birth
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Month
-
Day
Year
Date
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Student's Email Address
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example@example.com
Faculty/Staff Name
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First Name
Last Name
Position at Panola
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The Faculty/Staff is a full time employee at Panola College
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Yes
No
Please select the relationship of the student to the employee
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Dependent
Spouse
The student understands that they must maintain a minimum 2.0 GPA each semester
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Yes
No
The student is an Early admission student this semester
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Yes
No
The student will be a full time student
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Yes
No
Does the student have a Bachelor's Degree?
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Yes
No
What is the student's Cumulative GPA?
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Faculty/Staff Most Recent Tax Return
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Student Signature
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Faculty/Staff Signature
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Please verify that you are human
*
Note: The Faculty/Staff Scholarship may be funded from alternate financial resources if available.
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