North Knox Scholarship Foundation Application

North Knox Scholarship Foundation Application

This is for TEST purposes only! The actual application will be available in the spring.
Name

First NameLast Name
Birth Date

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com

School Data
Name of post secondary school for which applicant's scholarship is requested
School Type

4-year College/UniversityVo-TechCommunity College
School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student will:

Live on campusLive off campusCommute
Student will be enrolled:

Less than half-timeHalf-timeFull time
Anticipated date of graduation from postsecondary program

MonthDayYear
Date
Major field of study

Awards

Other Awards: please list the names and amounts of any grants or scholarships that you have been awarded for the coming school year. Use this chart or attach or own document below (MUST BE IN EXACTE SAME FORMAT AS THIS CHART)

	Name of Award	Amount	Granted	Pending
1
2
3
4
5

Other Awards:

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List all school activities in which you have participated during the past 4 years (student government, music, sports, ect.) List all community activities you have participated without pay during the past 4 years (Red Cross, church work, volunteer work). Indicate all special awards and honors. Use this chart or attach or own document below (MUST BE IN EXACTE SAME FORMAT AS THIS CHART)

	Activity	# of Years Participated	Special Awards, Honors, Offices Held
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15

List of activities:

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Personal Data: Describe your work experience during the past 4 years. Indicate dates of employment in each job and approximate number of hours worked each week.

	Position	Date From (mo/yr)	Date To (mo/yr)	Hours Per Week
1
2
3
4
5

Make a statement of your personal plans as they relate to your educational and career objectives and future goals. Use this space or attach or own document below.
Personal Statement:

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Please describe how and when any unusual family or personal circumstances have affected your achievement in school, work experience, or you participation in school and community activities. Use this space or attach or own document below.
Personal Circumstances:

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Transcript
Please attach a copy of your transcript

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Applicant Appraisal
Please provide the email address of the teacher you would like to have fill out an appraisal
example@example.com

Suggested Parent Contribution Questionnaire

Estimates are acceptable based off most recent 1040 Form
Adjusted gross income (FORM 1040 - Line 37)
Total income of father or self if independent student
Total income of mother
Total cash, checking, savings, cash value of stocks, ect. (exclude retirement plan funds, IRA, 401(k)).
Total number of family members attending a postsecondary school at least half-time during the upcoming school year, including applicant- do not include parents

North Knox Scholarship Foundation Application

School Data

Awards

Transcript

Applicant Appraisal

Suggested Parent Contribution Questionnaire

Scholarships