Scott Community College Foundation

Scott Community College Foundation

Scott Community College Future Leaders Scholarship Application

The Scott Community College Future Leaders Scholarship was created to inspire students to become recognized leaders while at Scott Community College. Students receiving this scholarship must be incoming high school seniors in the upper half of their graduating class and demonstrate involvement in at least one extra-curricular activity. This award is for the 2017 Fall and 20182013
Spring semesters in the amount of $250 per semester (total $500).

Name Date ___________________

Address ______________________________________________________________________

Street City State Zip

Email address:

Phone Number ___________________

High School: ___ Assumption High School ___ Bettendorf High School ___ Davenport Central High School ___ Davenport North High School ___ Davenport West High School ___ North Scott High School ___ Pleasant Valley High School Mid City High School

Class Rank / Intended program of study at SCC __________________________

If you are selected to receive this scholarship, you must register for the Fall semester by August 4th, maintain full-time enrollment status (12 credit hours or more), and maintain a Grade Point Average of 2.5 or higher at Scott Community College. Follow-up information will be mailed to you if you are selected as a recipient.

I authorize SCC to contact my high school to verify my academic eligibility for this scholarship.

Signature _____________________________________ Date _________________

Please return this form to the Foundation Office at Scott Community College,

500 Belmont Road, Bettendorf, IA 52722 or fax to: 563-441-4066

______________________________________________________________________________

FOR OFFICE USE ONLY:

Received: Entered: Enrolled: