Operation Roundup Scholarship Application

Please read through the entire application before you begin to ensure you have all the necessary information and attachments. You will not be able to save work and return at a later time.

If you have any questions about the application, contact Anna Smith at Tri-County EMC at annas@tri-countyemc.com or 478.986.8126.
GUIDELINES

1) Applicants must live in a household served by Tri-County EMC.

2) Recipient must be enrolled in an undergraduate or graduate program at a U.S. accredited college, university or technical school and have maintained a 2.0 average or better on a 4.0 scale.

3) Priority will be given to non-traditional students. This may include individuals who are working full or part-time who have returned to school.

4) Recipients cannot receive more than $2,000 in a two-year period.

5) The scholarships will be awarded in June and December annually. A total of $4,000 will be awarded annually.

6) Applications should be submitted by April 15 and October 15.

7) The funds may be used to pay tuition and purchase books. Students may be reimbursed for tuition and books with proper receipts or funds can be paid directly to the school.

8) Applications are judged based on academic success, financial need and community involvement.

9) Applications are scored by an independent panel of judges.

10) Applicants must submit an essay of 500 - 750 words that is a typed autobiographical sketch referencing plans, community service involvement and achievements accomplished and/or awards received.

CHECKLIST

A completed application will include:
- an official transcript
- a 500-700 word autobiographical essay
- enrollment verification from the college/univeristy you are attending or plan to attend
- 2 letters of recommendation
- total adjusted gross income of parent/spouse as listed on the previous year's tax return
- Annual cost of any other household member already attending college
- total dollar value of any scholarships you have already received

Contact Information
Full Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail
Cell Phone

Area CodePhone Number
Home Phone

Area CodePhone Number
College ID Number, if available
Legal Guardian Name

First NameLast Name
Legal Guardian Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Legal Guardian Email
Legal Guardian Cell

Area CodePhone Number
Legal Guardian Home

Area CodePhone Number

Attachments
Please attach the required items below.
Official Transcript from the school you currently attend

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A 500-750 word, typed autobiographical essay referencing future plans, community service involvement and achievements accomplished and/or awards received.

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1st Letter of Recommendation

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2nd Letter of Recommendation

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Enrollment Verification from School You Plan to Attend

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If you would rather upload all of your necessary files as one document, please use the next field.
I am including all of the required attachments in one document.

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Community Involvement
Please use the space below to describe your involvement in the community.
Participation in Community Service Activities
Membership in Organizations
Offices Held in Organizations
Honors and Recognition Received
Extracurricular Involvement (example: sports, band)

College/University Information
University or College You Are Attending or Plan To Attend
If you have not started at the above school yet, when do you plan to start?
Contact Person at College/University
Contact Person at College/University Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Contact Person's Phone Number

Area CodePhone Number
Contact Person's Email
Status in School

High School SeniorFreshmanSophomoreJuniorSeniorGraduate SchoolTechnical School
Tuition
Is the above tuition per quarter or semester?

QuarterSemester

Financial Need Assessment
For the next two questions, refer to the prior year's income tax return for your parents or that of you and your spouse.
Total Adjusted Gross Income
Other Non-Taxable Income
Number of Family Members Living In Household
Number of Family Members Attending College (other than yourself)
Annual Cost Per Member
Dollar Value of Scholarships Already Secured
Are there any other factors that influence your financial need?

By signing, I certify that the information on this application is true and correct to the best of my knowledge.
Should be Empty:

Contact Information

Attachments

Community Involvement

College/University Information

Financial Need Assessment