Scholarship Application

(Application in MS Word can be downloaded at

Full name:

Home address: City/State/Zip:

Phone: Email:

Age: Birth Date: Gender (M/F):

High school: Year of graduation:

Class rank: out of students SAT score: ACT score:

Father’s* name, occupation & company:

Mother’s* name, occupation & company:

* Or other legal guardian

Number of siblings: Number of siblings in college:

Annual income of both parents from most recent year’s income tax filing: Year: Total $

Are you willing to provide documentation of the above amounts if requested? Yes No

(double click to “check” box)

Please list any other means that have been set aside for you to attend college. (Example: Texas Tomorrow Fund, Savings Account, child support, etc.): Total $

What percentage of help do you anticipate your family giving you for college? %

Have you been accepted into Texas A&M University: Yes No (double click to “check” box)

If yes, date of acceptance:

Must include a copy of your acceptance letter or proof of admission with this application.

What is your expected major?

Do you plan on joining the Corps of Cadets?

List jobs you have held or work done while in high school:

Employer / Type of work / # hours/week / Start/end date

What honors or awards have you received (school or non-school related):

List high school activities and organizations you have participated in:

List activities and organizations outside of school:

Briefly explain why you have chosen your college major:

What are your professional or vocational objectives?

Briefly explain why you want to attend Texas A&M University:

Please add any additional information you think would be helpful to the scholarship committee:

By signing this application you agree to the following:

  • All applications and attachments become property of the Williamson County A&M Foundation Inc.
  • The Williamson County A&M Foundation and/or Club may publicly disclose and publicize the non-financial information in this application (e.g.: name, grades, class standing, etc.).
  • I agree to provide a personal photo to be used for possible online promotion of scholarship winners, send attached photo to (do not attach photos to application).
  • I have read the Qualifications listed on the website for the scholarship application.
  • I certify that information in this application is true, correct, and complete to the best of my knowledge.
  • I agree to provide copies of IRS Form W-2 statement(s) to verify income if requested(for SSN privacy DO NOT attach copies of W-2’s to this application).

Applicants’ signature: Date:

Parents’ or Guardians’ signature: Date:

Mail completed application to:William Peckham, Scholarship Chairman

Williamson County A&M Foundation, Inc.

407 Round Rock Ave.

Round Rock, TX 78664

--- APPLICATIONS MUST BE RECEIVED BY APRIL 1ST ----

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