Scholarship Application Form

Application Form

Collin E. Smith Memorial Scholarship Fund
The information provided on this form will be used by the Collin E. Smith Memorial Scholarship Fund committee to select recipients for scholarships. It is important that you give correct and complete details concerning your college/career plans, activities, and other requested information. Scholarships are available for two-year junior or community college, technical school, or other institution from which a certificate of completion may be attained.
I. Personal Data
Student Name*

First NameLast Name
Student Email*
example@example.com
Phone Number
Please enter a valid phone number.
Application Type*
II. Academic and Vocational Information
Current School*
Student ID
ID at your current school
What year did/will you graduate high school?
What college or trade school do you plan to attend or are already attending?*
What vocation are you interested in pursuing?*
Other vocation pursuit:
III. Family Information
Current Living Arrangements*

I live at home with both parentsI live in a single parent householdI have other living arrangements
Please describe your living arrangements.

Please list other family members in your household

	Name	Relation	Age	School or Occupation
1
2
3
4
5
6
7
8

Number of siblings who will be in college next year
Father's Name

First NameLast Name
Father's Email
example@example.com
Work Phone
Please enter a valid phone number.
Mobile Phone
Please enter a valid phone number.
Mother's Name

First NameLast Name
Mother's Email
example@example.com
Work Phone
Please enter a valid phone number.
Mobile Phone
Please enter a valid phone number.
IV. Essay
List and describe extra-curricular activities and your involvement. (include dates and offices held if applicable)*
How did you gain interest in pursuing a career in a trade (such as Welding, HVAC, Electrical, Plumbing, Construction Science)? *
Describe any trade-related experience, such as internships, projects, or coursework (include dates and details).
How will this education/degree/certification help you in your career? *
How will you use this college/trade program experience to give back and serve others?*
What would it mean to you to receive a Collin E. Smith Memorial Scholarship?*
How did you learn about the Collin E. Smith Memorial Scholarship Fund?
Consent*

I have read and understand the conditions of the Collin E Smith Memorial Scholarship Fund as explained on the website. I give permission to officials of my institution to release transcripts of my academic record and other information requested for consideration of the CES Memorial Scholarship. I understand that this application will be available only to qualified people who need to see it in the course of their duties. I waive the right to access letters of recommendation written on my behalf. If selected as a CES MSF Scholarship Recipient, I agree to the recipient requirements and understand if I do not meet these requirements, I will no longer receive the Collin E Smith Memorial Scholarship funds. I affirm that all of this application is my own work and the information contained herein is true and accurate to the best of my knowledge and belief.
Consent*

I certify that I do not have a criminal record, felonies, nor serious driving offenses, including DUI, DWI, reckless driving, or similar charges. Checking this box serves as my signature.
Consent*

I also consent for the Collin E Smith MSF can use my photos on the application process and for related marketing and website uses. Should I win the multi-year scholarship award, I consent to join the mentorship program.
Upload 1-3 photos, including at least one head shot, of yourself that we may use on our website or social media. The photos are for internal use and the headshot will be used on the application to be reviewed by the committee and the others on the website.*

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IV. Signature
By signing the space below, you are certifying that all information is correct and that you are the person completing this scholarship application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.
Student Signature*

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Application Form

I. Personal Data

II. Academic and Vocational Information

III. Family Information

IV. Essay

IV. Signature