GEER Scholarship Application - Central Piedmont CC

YOUR INFORMATION

Please note this application only needs to be filled out ONE time for each person.

Name*

First NameLast Name

Email Address*

example@example.com

Date of Birth*

Date

Address*

Street Address

Street Address Line 2

CityState

Postal / Zip Code

Primary Phone*

Area CodePhone Number

Primary Phone type

Alternate Phone

Area CodePhone Number

Alternate Phone type

Student Status*

What's your Central Piedmont student ID number or social security number? *

Gender

FemaleMaleIdentify Differently

Ethnicity

Hispanic/LatinoNon-Hispanic/Latino

Race

Current Employment Status*

What is your current or most recent job title and company name? *

Position, Company

If you are not currently employed, what was the month and year your last employment ended?

What is your current Monthly Income (Individual Gross)*

Please share estimated personal monthly income before taxes.

What is your current Household Monthly Income (Gross, including self)*

Please share estimated combined household income before taxes.

Highest Education Level*

Please choose program area of interest:*

Tell us about your career goals and how the scholarship program can help you reach them? (please provide a thoughtful answer) *

Tell us a little about your work, career & education/training history:

I attest that I am a resident of North Carolina, employed in North Carolina, OR intend to be employed in North Carolina

YesNoOther

Have you or members of your family been directly or indirectly affected by COVID-19?*

YesNo

If yes, how?

Do you have any current or upcoming financial needs (check all that apply):

Do you have reliable transportation? (access to bus is acceptable)*

YesNo

Do you currently work for Central Piedmont Community College?*

YesNo

Some programs (such as healthcare and truck driving) require a drug screen and/or background check to enter the program or for employment: Are you able to pass a criminal background check and/or drug screen?*

YesNoMy program does not require thisOther

Please upload your most recent resume (optional).

Browse Files

Please upload a recent professional photo (optional).

Browse Files

Do you receive Food and Nutrition Services in Mecklenburg County? For example: EBT or food stamps. This may allow us to provide additional funds and resources*

Are you a United States Military Veteran?*

NoYesprefer not to answerOther

Please Share With Us How You Learned About the Program

E-Signature*

Date*

Date

Your application does not guarantee that you will be chosen for a GEER or Workforce Scholarship. This application does not constitute a legal contract. Other information may be required to determine eligibility. This application is subject to revision. Eligibility and requirements are subject to change without notice. Applicants will not be notified of any changes in the application or the application process. It is each applicant’s responsibility to make sure that they have a current and up-to-date application.

Background for Workforce Resilience Grant Program (GEER II):
Under the Governor’s Emergency Education Relief Fund (GEER Fund), the U.S. Department of Education
awards grants to Governors to provide local educational agencies (LEAs), institutions of higher education
(IHEs), and other education-related entities with emergency assistance due to COVID-19. Under the
“Certification and Agreement for Funding under the Education Stabilization Fund Program Governor’s
Emergency Education Relief Fund” (CFDA Numbers: 84.425C), the Governor of NC established the
Workforce Resilience Grant for eligible NC Community College students.
Eligibility Criteria:
At a minimum, eligible students applying for this scholarship must:
• Be able to attest they are a resident of North Carolina, employed in North Carolina, or intend to be
employed in North Carolina.

• Be enrolling in Workforce Continuing Education (WCE) pathways/courses leading to an NC
Workforce Credential identified as either Essential or Career level

For Short‐Term Workforce Development (STWD) students:

At a minimum, eligible students applying for this grant must be:
1) A resident of North Carolina as outlined in G.S. 116‐143.1 and following the coordinated
and centralized residency determination process administered by the State Education
Assistance Authority known as NC Residency Determination Service (RDS).
2) A Student enrolling in Workforce Continuing Education (WCE) pathways/course(s)
leading to an N.C. Workforce Credential identified as either Essential or Career Level.
These pathways may consist of a single WCE course or a series of courses. The list of
eligible credentials is available at https://nccareers.org/credentials.

Residency Determination:
Before submitting this application, you must complete residency determination via
https://ncresidency.cfnc.org/residencyInfo/ and be determined to be a resident of
North Carolina. Upon completing this step, you will be provided a Residency
Certification Number (“RCN”)

Application Attestation:
I have read and understand the requirements for assistance. I attest that the information
provided on this form is complete and correct to the best of my knowledge.

*Applicant’s Ethnic Group: Ethnic identification is required by the Office of Civil Rights of the Department of Health, Education, and Welfare to assure compliance with the Civil Rights Act. Ethnic origin is not a factor in consideration for scholarship awards; all applicants are considered without reference to creed or race.

If you are experiencing technical issues submitting your application, please call (704) 330-2722 x3644

Note: As of May 2023 the STWD specific funds have been exausted. The following is only for reference of past information. Short‐Term Workforce Development Funds Note: We have access to some additional scholarship funds to support students enrolling in continuing education pathways at Central Piedmont. In order to access these specific funds we need to know which of our scholars are classified as NC residents. Even if you do not qualify as "in state" we may be able to support you.

For consideration for that grant you must complete residency determination via https://ncresidency.cfnc.org/residencyInfo/ and be determined to be a resident of North Carolina. Upon completing this step, you will be provided a Residency Certification Number (“RCN”), which should be provided below.

Residency Certification Number (“RCN”):

from RDS: ncresidency.cfnc.org

Application for Workforce Scholarship Program (GEER)

I have read and understand the requirements for assistance. I hereby declare that the information provided on this form is complete and correct to the best of my knowledge.