5 South Mt. Vernon Avenue

5 South Mt. Vernon Avenue

Uniontown, PA 15401

724-437-8600

2018 College Scholarship Application

Instructions:

Please print clearly and use ONE paper clip on the entire application. DO NOT STAPLE.

All required documents must be attached. Incomplete applications will not be accepted.

Applications must be post-marked by March 23, 2018 and mailed to CFFC.

NAME OF SCHOLARSHIP: Fayette County Community Service All Stars was created in 2004 to recognize and honor deserving community-minded students.Applicant must be a U.S. citizen residing in Fayette County and graduating from one of the following Fayette County High School: Albert Gallatin, Brownsville, Frazier, Laurel Highlands, Uniontown, Connellsville, Geibel.

STUDENT INFORMATION

NAME: ______

(Prefix)(First)(MI)(Last)

ADDRESS: ______

(Street Address – No P.O. Box)(City) (ST) (ZIP)

HOME PHONE: ______ALTERNATE OR CELL PHONE: ______

E-MAIL ADDRESS: ______BIRTHDATE: ____/_____/_____

EDUCATION (Current Official Transcript must be attached)

What is your Cumulative GPA? _____

I am currently attending the following high school: ______

High School Address: ______

(Street) (City) (ST) (ZIP)

Estimated Graduation Date: ______

SAT Score: TOTAL Math/Reading/Writing: ______ACT Score: ______

What will be your Major/Field of Study? ______

ACTIVITIES

Within the last four years, I’ve been a member of the following Club(s)/Committee(s): ____________

______

Special Awards, Honors or Other Information: ____________

______

Within the last four years, I’ve participated in the following sports: ______

______

WORK EXPERIENCE

Name of Employer: ______Type of Work: ______

Start – End Dates: ______Approximatelyhow many hours do you work each month? ______

Name of Employer: ______Type of Work: ______

Start – End Dates: ______Approximately how many hours do you work each month? ______

COMMUNITY SERVICE/VOLUNTEER EXPERIENCE

Please attach a Community Service “Resume” for the last three years (grades 10-12).

PARENT INFORMATION

Father: ______Mother: ______

Address: ______Address: ______

______

Phone Number: ______Phone Number: ______

Employer: ______Employer: ______

Job Title: ______Job Title: ______

How many siblings do you have? ______Including yourself, how many will be attending college in the Fall? ______

REQUIRED DOCUMENTS

IF THESE DOCUMENTS ARE NOT ATTACHED,

YOUR APPLICATION WILL NOT BE ACCEPTED

1. A copy of your most recent OFFICIAL transcript.
2. Please write a 750 word essay titled “Why I am Involved in Community Service.”
3. Community Service “Resume” for the last three years (grades 10-12).
4. Applicant must submit a letter from the guidance office stating that the applicant is in good standing at his/her school and have a cumulative 3.25 GPA or better.

OPTIONAL DOCUMENT(S)

1. Applicant may choose to have letters of support submitted from organizations for which the applicant volunteers.

CONSENT & VERIFICATION

In submitting this application, I certify that the information provided in this application is complete and accurate to the best of my knowledge. I understand that all decisions made by the CFFC Scholarship Committee(s) are final and not subject to review or appeal. I further understand that any information provided in this form may be shared with committee members and donors of the sponsoring scholarships. Also, I understand that falsification of information may result in termination of any scholarship granted. If selected to receive a scholarship, I agree to the use of my name, likeness, and information contained in my application (excluding any financial information) for promotional purposes for the Community Foundation of Fayette County, without further compensation or notification.

Student’s Signature: ______Date: ______

Printed Name: ______

Parent’s Signature: ______Date: ______

(If student is under 18 years of age)

Printed Name: ______

If you are selected to receive an award, you will be notified in May.