BooneCounty-WestVirginiaUniversity Alumni and Friends

Scholarship Application forWest VirginiaUniversity or its Affiliated Institutions

This application assists us in providing a BooneCounty high school senior financial assistance to attend West VirginiaUniversity or one of its affiliated institutions. The award is based on several factors. In order to apply the applicant must complete the attached “Scholarship Application” and provide a transcript of grades for grades 9-12. In addition, the applicant must sign the release of information below.

I am requesting that a copy of my transcript of grades be made available to the BooneCounty -- West Virginia University Alumni and Friends. I am also giving the West Virginia University Financial Aid Office the authority to release my amount of financial need to the BooneCounty -- West Virginia University Alumni and Friends in order for them to determine my eligibility for this scholarship.

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DateApplicant Signature

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DateParent/Guardian Signature

Return the completed application to: Boone County Chapter, WVU Alumni Association, P.O. Box 38, Madison, WV25130no later than March 1, 2009. Please feel free to attach additional pages if needed.

The scholarship recipient(s) will be announced at the Awards Day Ceremony.

BooneCounty-WestVirginiaUniversity Alumni and Friends

Scholarship Application

For

____West VirginiaUniversity ____West Virginia University Institute of Technology

Morgantown, WV Montgomery, WV

____ PotomacState College of West VirginiaUniversity

Keyser, WV

Name: ______

First Middle Last

SSN: ______Date of Birth:______

Home Address: ______

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Home Phone Number: (____)______

Cell Phone Number (_____)______

Email: ______

Parent(s) or Guardian(s) names: ______

Occupation of Father: ______Mother:______

Family Gross Income for 2008: [ ] $45,000 and Below [ ] $45,000-60,000

[ ] $60,000-$70,000 [ ] $70,000-$80,000 [ ] $80,000-$90,000 [ ] $90,000-$100,000 [ ] above $100,000 please specify______

Age and number of Sibling(s):______

Number in college______

High School Attending: ______

Date of Graduation: ______Grade Point Average: ______

Rank in Class: ______Major Course of Study: ______

Career Goal: ______

When will you enroll at WVU or one of its affiliated institutions? ______

What is your planned major? ______

Will you be attending full time?___yes ___no

Do you qualify for the Promise Scholarship? ___yes ___no

Have you received any other financial aid for the coming year? ___yes ___no

If so, please list the name and amount of these grants/scholarships: ______

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If you have attended college or received college credit while in high school, please list total credit hours and grade point average. ______

List of Extra-Curricular Activities: (please include awards and community service while in high school)

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Briefly, state your reasons for seeking the Boone County -- WVU Alumni and Friends Scholarship including any information or special circumstances to support your application: ______
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List other colleges and universities that you are still considering: ______

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