Chicago Crossroads College Scholarship Application Form

Chicago Crossroads Corvette Club Student Scholarship Application
Date

MonthDayYear
DateHourMinutesAM/PM Option
Student Name*

First NameMiddle NameLast Name
Contact Email*
example@example.com
Contact Phone #*
Date of Birth*

MonthDayYear
Home Address*

Street Address

Street Address Line 2

CityState

Zip Code
Educational Information
Current High School Attending*
Latest GPA Percentile*
Date Expected to Graduate*

MonthDayYear
Academic awards and/or honors you received in High School
Are you a member of any organization(s) outside your school? Please provide information

Directions
The following document(s) are REQUIRED for your consideration in the scholarship application submission process:

Official or Unofficial Transcript(s)

Two (2) Signed reference letters

Typed 400 - 500 word Essay

Completed Application
Have Questions? Please send email to: ChicagoCrossroadsSecretary@gmail.com

Application Review
Application Checklist (Must provide All)

Completed Application(2) Two signed Reference lettersTyped 400 - 500-word EssayCopies of Official and/or Unofficial Transcripts
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

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Name of Applicant

First NameLast Name
Date Signed by Applicant*

MonthDayYear
Date
Should be Empty:

Chicago Crossroads Corvette Club Student Scholarship Application