Local Scholarship Application Form

First State Bank Scholarship Application

At First State Bank, we believe strong communities start with investing in the next generation. For more than a century, we've been proud to serve our neighbors - not just through banking, but by showing up, giving back, and supporting local dreams. The First State Bank Scholarship Program was created to encourage graduating seniors across our market areas as they take the next step in their education. We are honored to support students who demonstrate hard work, leadership, service, and a heart for their community. This scholarship is open to graduating seniors from all high schools within First State Bank's market areas who plan to attend an accredited college, university, or technical school.
Applicant Information
Student's Full / Legal Name*

First NameLast Name
Student Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Student Phone Number*

Area CodePhone Number
Student E-mail*
Student Birth Date

MonthDayYear
School Information
High School Name *
School District *
High School Graduation Year *
Current GPA*
GPA Scale*

4.0 ScaleOther
College Plans
College/University/Technical School You Plan to Attend *
Planned Area of Study/Major*
Enrollment Term*

FallSpringSummer
Have you been accepted to this institution?*

YesNo
Activities & Community Involvement
Please list your school activities, work experience, leadership roles, and/or community involvement *
Essay Question:

Please select ONE prompt and provide your response (500 words or less):
1. How have you made an impact in your school, workplace, or community?
2. What does community mean to you, and how do you hope to give back in the future?
File Uploads:
High School Transcript (File Upload - PDF or Image) (Unofficial Transcript Accepted)*

Browse Files

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Letter of Recommendation (File Upload - PDF or Image) From a teacher, counselor, coach, employer, or community leader*

Browse Files

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Optional Information:
Is there anything else you would like the scholarship committee to know?
Certification & Signature:
I certify that the information provided is accurate and complete to the best of my knowledge.*

YesNo
Signature*

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Submission Time*

MonthDayYear
DateHourMinutesAM/PM Option
Can we do a confirmation screen?*

YesNo
Thank you for applying!

We appreciate your interest in the First State Bank Scholarship Program. Recipients will be notified by email. If you have questions, please contact Brenna.Grewing@firststate.bank
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First State Bank Scholarship Application

Applicant Information

School Information

College Plans

Activities & Community Involvement

Essay Question:

File Uploads:

Optional Information:

Certification & Signature:

Thank you for applying!