Nate Clark Memorial Foundation College Scholarship Application Form

Nate Clark Memorial Foundation HCHS College Scholarship Application Form

Applications due by May 15th, 2025
Nate Clark tragically lost his life the evening of December 7th, 2021, in a multi-vehicle accident. Nathanael Paul Clark, the first-born child to Heather and Todd Clark, and big brother to Halle (2013 HCHS graduate), enriched the lives of everyone he met in his brief 27 years with us. An exceptional student, mentor, friend, and member of the 2012 HCHS graduating class, Nate created community wherever he lived and leaves all who knew him better than before. Nate strongly believed in the value of higher education, and in his memory the Nate Clark Memorial Scholarship was established to support future generation’s pursuit to better themselves, their families, and their communities.
Qualifications:
- 2025 graduate from Harnett Central High school
- Plans to attend a degree program in Fall 2025.
- 3.2 unweighted grade point average (GPA)
- Be accepted into an accredited college or university
- Possess qualities of good citizenship
Name*

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

MonthDayYear
Date
Sex*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Parent/Guardian Name(s)*
Educational Information
Name of High School Attended*
Current GPA*
Graduate Date*

MonthDayYear
Date
SAT Score*
ACT Score*
Extra-Curricular Activity*
Explain involvement in any Sports, Clubs, Community Service, etc.
Post-Graduation Information
College you are attending:*
Address:
Have you been accepted?*

Essay
Complete a 250-word essay based on:

What does community mean to you, and how do you aspire to give back to your community and loved ones through the pursuit of higher education?
Upload Your Personal Statement Now*

Preferred file formats are .doc and .pdf
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Letters of Recommendation, Transcript, Resume, and Acceptance Letter
Upload Your Letter of Recommendation from a Teacher Here*

Preferred file formats are .doc and .pdf
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Upload Your Letter of Recommendation from a Community Leader Here*

Preferred file formats are .doc and .pdf
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Upload your Official High School Transcript Here*

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Upload your Resume Here*

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Upload your College Acceptance Letter (if available) Here

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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
Name of Applicant

First NameLast Name
Date Signed by Applicant

MonthDayYear
Date
Should be Empty:

Nate Clark Memorial Foundation HCHS College Scholarship Application Form

Educational Information

Post-Graduation Information

Essay

Letters of Recommendation, Transcript, Resume, and Acceptance Letter