Scholarship Application

Scholarship Application
Applicant's Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Age*
Name of High School*
Graduation Date*
Name of College/University*
Course of Study
Student Email*
example@example.com
Parent/Guardian Name(s)*
CVEC Account Number*

Graduating High School Seniors
Name of High School
Size of Graduating Class
Projected Class Rank
Cumulative GPA
(Based on a 4.0 scale)
College or University Plans
First Choice
College or University Plans
Second Choice
College or University Plans
Intended Major
Employer
Do you intend to work while attending college?

Returning College Student (or individual returning to school after an extended absence)
Name of College and Major (or High School, if never attended college)
If you've never attended college, size of graduating class:
Cumulative GPA
(Based on a 4.0 scale)
If returning to school after an extended absence, please include your current employment information and your spouse's (if applicable) current employment information.
Occupation
Employer
Spouse's Occupation
(if applicable)
Spouse's Employer
(if applicable)

List potential sources of financial aid or anticipated funding for our college your college tuition and supplies (family support, PELL Grant, student loan, scholarship, etc.) and indicate status.

	Source	Amount	Pending/Approved

Extracurricular and Community Activities and Academic Awards
List any school-related or community activities and special honors or academic honors you have received. (If additional space is needed, please upload a separate document at the end of application.)
How did you hear about the CVEC scholarship?
Signature*

Clear
Submission Date

MonthDayYear
Please upload or mail the following items.

1. Attach one letter of reference testifying to your talents, leadership, and seriousness of purpose. (Limit 250 words*)

2. Attach an essay completed by you (the applicant) testifying to your talents, leadership, and seriousness of purpose. (Limit 300 words*)

3. Attach an official transcript of college or university grades. If you’re a high school senior and an official transcript of your highschool grades are not yet available, a high school counselor must verify and certify the accuracy of the stated GPA by signature and date (see application).

4. A copy of actual ACT or SAT score report. (Only ACT/SAT reports will be accepted.)

Mailing Address:
Concho Valley Electric Cooperative
Attn: Scholarship Committee
P.O. Box 3388
San Angelo, TX 76902
Cancelof
Are you mailing the items to the cooperative to complete the submission?

YesNo
In applying for this scholarship, I am aware that I must provide Concho Valley Electric Cooperative with proof of enrollment from an accredited post-secondary institution of which I will be considered to be a full-time student.

I agree to permit review of this application and my school records by anyone representing Concho Valley Electric Cooperative and its appointed Scholarship Review Committee.
Should be Empty:

Scholarship Application

Extracurricular and Community Activities and Academic Awards