Beaufort County Community College Foundation Scholarship Application

Name

First NameMiddle NameLast Name

(Current BCCC Students) Student ID:

Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Home Phone

Format: (000) 000-0000.

Cell Phone

Format: (000) 000-0000.

BCCC Email

example@live.beaufortccc.edu

Have you completed the current FAFSA?

*Scholarships will not be awarded if a current, completed FAFSA is not on file with the financial aid office.

Please select the semester you applying for:

County of residence:

Resident for how many years?

List any other scholarships you will receive for the current semester with the amount of the award:

Did you graduate from high school?

What year did you graduate high school?

Name of high school attended:

High school GPA:

ex: 3.8

How many semesters have you completed at BCCC as of the end of the current semester?

(Only include Fall & Spring)

Names of all Colleges or Universities Attended:

Do you hold a degree from another college or university?

Degree held:

Do you plan to transfer to a four-year degree school after you graduate from BCCC?

Do you have a parent currently employed at BCCC?

If so, please list their name:

What is your major/course of study at BCCC?

What will be your status in your program in the upcoming semester?

Have you received a scholarship in the past 12 months?

Does the Foundation Office have a photograph of you on file, and if so may we use it for publicity if you are awarded another scholarship?

If selected to receive a scholarship, will you be willing to speak to scholarship donors about how the scholarship helped you attend BCCC?

Please provide a statement discussing how you intend to use your degree after graduation:

Please provide a statement discussing the impact of this scholarship on you and your family:

Please upload additional documents here:

Please attach applications for the David Clark, Thomas Minges, and SECU scholarships if you are applying for those as well.

PUBLICITY CONSENT & RELEASE

I hereby consent to Beaufort County Community College (BCCC) to use all photographs, motion pictures, video or sound recordings of myself taken by BCCC or its agents or employees, in which I may be included in whole or in part, in connection with any activity or ceremony sponsored by or conducted by BCCC, or in connection with any publication, web site, literature, broadcast or promotion published, broadcast, televised or otherwise disseminated by BCCC, its agents, employees, assigns, or licensees, without my prior review or approval and without compensation to me of any nature.

I hereby release BCCC, its agents, assigns, licensees and employees from any and all claims, demands, damages, suits and obligtations otherwise inuring to me on account of the publication, reproduction, use, sales, broadcast, transmission, distribution and dissemination of such materials.

I am 18 years of age or older and I am competent to contract in my own name. I have read this release before signing below, and I fully understand the contents, meaning and impact of this release. I understand that I am free to address any specific questions regarding this release by submitting those questions in writing prior to signing, and I agree that my failure to do so will be interpreted as a free and knowledgeable acceptance of the terms of this release.

If selected to receive a scholarship, do you agree to the BCCC publicity release as stated above?

CERTIFICATION

This application contains accurate information to the best of my ability. Falsification of information will result in the termination of any scholarship granted. In addition, I understand that a copy of my application may be shared with members of the Beaufort Community College Foundation Scholarship Selection Committee and this application becomes the sole property of the Beaufort Community College Foundation. It is my responsibility to inform the Beaufort Community College Foundation Office if any information on this application or my academic standing changes.

I authorize release of my name and photograh to media if awarded a Foundation Scholarship. I understand all scholarship notifications will be sent to my BCCC email.

Signature