2018SCHOLARSHIP

APPLICATION FORM

Application Form

Personal Information

(All information received will be held in strict confidence)

Applicants Full Name: Date of Birth:

Address:

Home Phone: Cell Phone:

E-Mail:

Parent, Guardian and/or Sponsor’s Name:

Parent, Guardian and/or Sponsor’s Address:

Parent, Guardian and/or Sponsor’s E-mail Address:

Father’s Employer:

Mother’s Employer:

Sponsor’s Employer:

I certify that the information presented in this application is true. Applicant’s Signature: ______Date: ______

APPLICATION DEADLINE: April 1, 2018

Return completed application to: Brazos Valley API Scholarship, P.O. Box 1330,

Bryan, TX 77806

2018Scholarship Application

Basic Data

(Check all that apply)

I am currently attending High School and will graduate in May 2018.

I am currently a college student. List school attending and projected graduation date.

I am an adult Starting college Returning to college

I want to attenda:Trade Vocational Technical Professional school.

Check one: 2 yr. 4 yr.

I want to attend a two-year community college.

I want to attend a four-year college or university.

I am attending or applying to a graduate school.

College or University Which You Plan to Attend:

Applied Accepted(List college name and address)

Applied Accepted (List college name and address)

Planned Major or Degree

(What are your career goals and what would receiving this scholarship mean to you?)

*Note: If more space is needed please attach to the back of application.

2018 Scholarship Application

High School Academic Achievements

(Required by High School Seniors applying for the Brazos Valley API Scholarship)

EDUCATIONAL INFORMATION

Name of Student:

Name of High School:

Address of High School:

Cumulative High School Grade Point Average (GPA): ______

Class Rank at the end of last grading period: ______Number in Class: ______

SAT Mathematics Score: ______ACT Composite Score: ______

SAT Critical Reading Score: ______

SAT Writing Score: ______

SAT TOTAL SCORE: ______Other: ______

Icertify that the information presented on this application is true.

Signature of High School Representative: ______

Date: ______Title: ______

2018 Scholarship Application

List any Honors, Activities & Community Achievements

(Indicate any awards or honors that you have received or any offices held while participating in these organizations)

*Note: If more space is needed please attach to the back of application.

List any sports or extra-curricular activities in which you participate

(Include any school or community sports that you participate in)

*Note:If more space is needed please attach to the back of application.

List any community activities that you are involved in

(Include church, 4-H or any other organizations that you are active in)

*Note: If more space is needed please attach to the back of application.

2018 Scholarship Application

College Academic Achievements

(Required by Students currently attending a Vocational School, College or University)

  1. Checkall that applies: Vocational Community College University
  1. List name(s) and location(s) of educational program / institution you applied to or have attended:
  1. List degree(s) or certificate(s) you have earned or are working towards.
  1. Cumulative post-high school grade point average (GPA)
  1. College credits earned to date:
  1. Total College semester hours completed to date:
  1. Scheduled month and year your program / degree / certificate will be complete:

Attachments

  1. Copies of your previous semester(s) transcripts.
  2. Current semester schedule.

Employment Record

List most recent first

Employer:

Dates Employed:

Type of Work:

Employer:

Dates Employed:

Type of Work:

2018 Scholarship Application

General Scholarship Information

APPLICATION DEADLINE: April 1, 2018

All applications must be post marked no later than April 1st. Applicants are urged to apply early. No late applications will be considered!

Questions?

Contact Information:

API Scholarship Chairman: Ray Music

Phone: (281) 635-6033

E-mail:

Scholarship recipients will be notified upon completion of the selection process.

Recipients will be invited and urged to attend the API meeting on May 8th, 2018 to receive scholarship.

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Scholarship Year 2018/2019