Scholarship Application
CCF 2026-2027 Nursing/Healthcare Program Scholarship Application
County of Residence
Before applying, please verify the county that you live in. If your county is not listed, you will not be eligible.
Select County
*
Please Select
Collin
Dallas
Ellis
Hood
Hunt
Johnson
Kaufman
Tarrant
Personal Information
Please fill in the following personal information.
Name
*
First Name
Middle Name
Last Name
Email
*
example@example.com
Alt. Email (personal)
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Alt. Phone Number
*
-
Area Code
Phone Number
Father's Name
*
First Name
Last Name
Father's Occupation
Mother's Name
*
First Name
Last Name
Mother's Occupation
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Ethnicity and Race / Gender / Employment Status
For statistical and reporting purposes only, applicants are invited to share information regarding their ethnic background, gender, and current employment status. Providing this information is voluntary and will not impact scholarship eligibility in any way.
Ethnicity
Please Select
Hispanic/Latino
Asian or Pacific Islander
Non-Hispanic Black
American Indian or Alaskan Native
Non-Hispanic White
Some other Race
Gender
Please Select
Male
Female
Non-Binary
Prefer not to say
Employment Status
Please Select
Full-Time
Part-Time
N/A
Citizenship Information
Reminder: You must be a U.S. citizen, permanent resident, or qualified DACA status immigrant to apply for this scholarship.
Are you a U.S Citizen, resident or qualified DACA?
*
Yes
No
Academic Information
Please fill out your current academic status & information.
Student Status
*
Please Select
Full Time (12+ Credits)
3/4 Time (9+ Credits)
Part-Time (6 Credits)
Which nursing or healthcare program are you attending or accepted to?
*
Date of acceptance into nursing/healthcare program:
*
-
Month
-
Day
Year
Date
How many credits do you currently have?
*
What specific degree are you currently seeking?
*
Associates Degree (2 year program)
RN TO BSN
Traditional BSN
Accelerated BSN Program
LVN/LPN
Concurrent Program (ADN/BSN)
Other Healthcare Degree
Other
Expected graduation Date?
*
-
Month
-
Day
Year
Date
Expected credit load for year?
*
Do you currently hold a degree in nursing or another healthcare-related field?
*
Yes
No
If yes, please specify the nursing or healthcare degree you currently hold.
Financial Information
To determine eligibility we require the following financial information.
Adjusted Gross Household Income?
*
Number of family members in household?
*
Number of family members attending college this year?
*
Copy of your FASFA Summary Report (Previously the SAR) in PDF format:
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Work History/Volunteer/Community Service Activities-Resume
Please attach your resume with the application, detailing your work history for the past 3 years. Include all volunteer/community service and certifications. If these are listed on your resume, there is no need to include them separately.
Resume Upload
*
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Volunteer/Community Service Activities
Please list your volunteer/community service activities and certifications. If these are listed on your resume, there is no need to include them separately.
Please list your volunteer/community service activities.
Scholarship Essay
Briefly describe how a scholarship would help you to reach your educational and professional goals. Identify your goals and needs clearly. This essay is given strong consideration in the decision-making process. Maximum of 500 words. Please upload your essay in PDF or Word or email once complete to scholarships@ccfoundation.us
Essay Upload
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Signature
*
Date
-
Month
-
Day
Year
Date
Submit
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