2023 HCJ Scholarship Foundation Application

2023-2024 Application Form

Thank you for applying to the Harold C. Jennings Scholarship Foundation. In this application, you will be asked to provide information on your educational background and plans, financial situation, and activities and interests. Please answer all questions truthfully. If there are any discrepancies in your application materials, we will contact you and your parents or guardians for clarification.

Student and Parent Contact Information
Your (Student's) Name

First NameLast Name
Your (Student's) Phone Number

Area CodePhone Number
Your (Student's) Email
example@example.com
Name of Mother or Guardian 1

First NameLast Name
Phone Number of Mother or Guardian 1

Area CodePhone Number
Email of Mother or Guardian 1
example@example.com
Name of Father or Guardian 2

First NameLast Name
Phone Number of Father or Guardian 2

Area CodePhone Number
Email of Father or Guardian 2
example@example.com

Education Information
What school are you currently attending? If you are not currently in school, what is the last school you attended?
GPA (2021-2022)
GPA (2022-2023)
Please upload a copy of your transcript for the past year.

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Please upload a letter of recommendation (1 of 2).

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Note: One of these letters of recommendation must be from a teacher or counselor at the school you are currently attending. Cancelof
Please upload a letter of recommendation (2 of 2).

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Note: One of these letters of recommendation must be from a teacher or counselor at the school you are currently attending. Cancelof
What college do you plan to attend in the coming year?
Please upload proof of enrollment in the college you plan to attend in the coming year.

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FreshmanSophomoreJuniorSenior
Expected College Graduation Date

MonthDayYear
Date
Full-timePart-time
On campusOff campusWith parents/guardians
How many credit hours do you plan to carry per semester, quarter, or trimester?
Please provide the address of the college you plan to attend.

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please provide the phone number of the Financial Aid Office at the college you plan to attend.

Area CodePhone Number

Financial Information
Estimated Salary of Mother or Guardian 1
($)
Estimated Salary of Father or Guardian 2
($)
Estimated Total Household Income
($)
How many other dependents do your parents or guardians have?
How many of these dependents are college students?
Please describe any conditions that would drastically affect your financial situation during the upcoming college year.

Estimated annual college costs

Rows	Annual Cost ($)
Room/Board (on campus)
Room/Board (off campus)
Tuition
Meal Plans (if applicable)
Technology Fees
Other Fees
Other Fees
Other Fees

Total estimated annual college cost
($)
To verify the information above, please upload the Tuition & Fees Statement from the college you will be attending.

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Are you expecting to receive any grants or scholarship funds (i.e. HOPE, LIFE or Palmetto Scholarships, etc.)? If so, please list the source and the amount of these funds for the upcoming school year.

Rows	Program Name	Award Amount	Status - Awarded or Pending?
Program 1
Program 2
Program 3
Program 4
Program 5

Total award amount
($)
Please upload a copy of your FAFSA.

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Activities and Interests
Please list any hobbies, interest, or special activities.
Please write a brief description of any current or past jobs.
Please give a brief statement of your academic plans for college and for your career plans after graduation. Also include anything else you would like to share with the HCJ Scholarship Foundation Board of Directors.

I CERTIFY THAT ALL STATEMENTS OR INFORMATION I HAVE PROVIDED ABOVE ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. ANY DELIBERATE MISREPRESENTATION FOUND IN THIS APPLICATION MAY BE CAUSE FOR THE APPROVAL OF THIS APPLICATION AND MAY PROHIBIT ME FROM APPLYING AGAIN IN THE FUTURE.
Applicant's Signature

Clear
Name of Applicant

First NameLast Name
Date Signed by Applicant

MonthDayYear
Date
Parent or Guardian's Signature

Clear
Name of Parent or Guardian

First NameLast Name
Date Signed by Parent or Guardian

MonthDayYear
Date
Should be Empty:

2023-2024 Application Form

Student and Parent Contact Information

Education Information

Financial Information

Activities and Interests