CONTINUING EDUCATION SCHOLARSHIP 2025
Name: Last, First & Middle
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County Residence
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Address: City, State, Zip Code
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College Name and Address attending Fall 2025
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Home Telephone Number
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Cell Telephone Number
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Email Address
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Classification
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Sophomore
Junior
Senior
Grade Point Average
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Major
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List any extracurricular activities in which you have participated; include your leadership roles, if any, in those activities.
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List any special circumstances you think we should be aware of.
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Household Income; include any personal income. Please state source of income (Work, Public Assistance, Social Security Benefits, etc.).
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List the number of dependents claimed by your parents on their most recent Federal Income Tax Return.
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How many of the dependents are currently enrolled in a post high school program?
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Attach a short essay (200-300 words) about your accomplishments in college this year. Include what you enjoyed most, your greatest challenges, and your future plans.
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Provide your latest transcript.
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Provide a headshot.
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TYPE NAME (Your printed name and email address is considered as your electronic signature.)
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