Chris Holcombe Memorial Scholarship

SCHOLARSHIP ELIGIBLILITY

To be eligible for the Chris Holcombe Memorial Collegiate Scholarship, you must:

  1. Be a United States citizen. If the applicant’s transcript reflects a place of birth other than the United States, proof of naturalization must be provided with the scholarship application.
  2. Former Milam County, Texas resident or graduated from a Milam County high school.
  3. Will have graduated from high school at least one year prior to time scholarship payments are initiated in the Fall 2013.
  4. Have successfully completed or will have successfully completed thirty (30) semester hours of undergraduate college work by the time scholarship payments are initiated in Fall 2013.

SCHOLARSHIP INSTRUCTIONS

Complete the application as completely as possible in the space provided according to the following page schedule - please do not add pages or write on the reverse side of any page. A copy of your college transcript(s) listing all completed course work must be attached to the application for submission.

Personal Data...... Page 2

Application Certification...... Page 2

College/University/Career Information...... Page 3

Financial Information...... Page 3

Financial Need...... Page 4

Collegiate Activities...... Page 5

College Transcript(s) (does not have to be an official copy)...... Attachment

SCHOLARSHIP APPLICATION EVALUATION

Scholarship awards will be based on:

  • Financial need as demonstrated in application.
  • Scholastic ability/achievement.
  • Collegiate leadership and involvement.

SCHOLARSHIP APPLICATION DEADLINE

The completed application, with a copy of your college transcript(s) must be emailed directly to the Chris Holcombe Memorial Scholarship Committee at the email address below. Scholarship application must be received by deadline.

Deadline: June 30, 2013.

Chris Holcombe Memorial Scholarship Fund

SCHOLARSHIP AWARD

Annual award amount may be awarded to one qualified recipient or divided between qualified recipients as determined by the scholarship committee.

PERSONALDATA
Application Submission Category
Last Name / Click here to enter last name. /
First Name / Click here to enter first name. /
Middle Name (No Initials) / Click here to enter middle name. /
Nickname (if applicable) / Click here to enter nickname. /
Gender / Gender /
Home Address / Click here to enter address. /
City, State Zip / Click here to enter address. /
Telephone / Click here to enter phone number. /
E-mail Address / Click here to enter email address. /
Social Security Number / Click here to enter SSN. /
Date of Birth / Click here to enter birthdate. /
Are you a citizen of the United States? (Yes/No) / US Citizen /
When did you graduate from a Milam County high school? / Click here to enter the year graduated from high school. /
Click here to enter name of high school and city. /
APPLICATION CERTIFICATION
I certify that the information contained herein is correct and truthfully reflects my personal, collegiate and academic background and records. I agree that, if any information contained herein is found to be falsified in any way, my application will automatically become null and void. I hereby authorize any person, firm or entity to release to the Chris Holcombe Memorial Scholarship Fund, or the scholars donor, information concerning the subject matter of the statements I have made in this application, including, but not limited to, information concerning my academic record, activities, honors and awards, citizenship or residency, and financial situation. A copy of this authorization is agreed by the undersigned to have the same effect and force as an original. Any person, firm or entity releasing matters pursuant to this authorization is hereby absolved from any liability.
Signature of Applicant / By typing your name here, you certify information entered is accurate and truthful. / Date / Click here to enter a date. /
COLLEGE/UNIVERSITY CAREER PLANS
Name of College/University you are attending / Click here to enter name of school. /
Course of Study chosen for degree or certification / Click here to enter course of study. /
Department/College in which this degree plan is offered? / Click here to enter department/college. /
What is your preferred career choice? / Click here to enter career choice. /
Overall GPA / Major GPA / Total Hours Completed / Number of Semester from Graduation / Anticipated date of Graduation
Click here to enter GPA. / Click here to enter major GPA. / Click here to enter hours completed. / Click here to enter number of semesters. / Click here to enter anticipated graduation date. /
FINANCIAL INFORMATION
Expected College Cost and Personal Savings
College Cost
Tuition per semester hours: / $Enter tuition/semester hour.
Books & fees per semester: / $Enter cost of books & fees.
Housing per Semester: / $Enter amount spent.
Are you living in a dormitory? (Yes/No): / Choose an item.
Food per semester: / $Enter amount spent.
Recreation and travel per semester: / $Enter amount spent.
Name of Donor/Name of Scholarship or Loan You Currently are On or Have / $/Year / # of Years / Total Amount / Origination Date
Scholarship/Loan 1 Name / $Yearly amount / Enter length / $Total award / Enter start date /
Scholarship/Loan 2 Name / $Yearly amount / Enter length / $Total award / Enter start date /
Scholarship/Loan 3 Name / $Yearly amount / Enter length / $Total award / Enter start date /
Scholarship/Loan 4 Name / $Yearly amount / Enter length / $Total award / Enter start date /
In each of the categories listed below, indicate the amount of assistance you expect to continue to have to pay your college expenses each semester if you do not receive this scholarship.
$Enter amount / $Enter amount / $Enter amount / $Enter amount / $Enter amount / $Enter amount / $Enter amount
Scholarships / Loans / Parents / Personal Assets / Work / Other / TOTAL

Briefly state why you need additional financial assistance and why you should receive this scholarship.

Click here to enter text.

COLLEGIATE ACTIVITIES

List collegiate activities and leadership responsibilities (include social and service clubs, sororities/fraternities, church, campus committees, etc.)
Year(s) / Organization Name / Leadership
Year / Organization Name / Offices Held, Committees, Other Leadership /
Year / Organization Name / Offices Held, Committees, Other Leadership /
Year / Organization Name / Offices Held, Committees, Other Leadership /
Year / Organization Name / Offices Held, Committees, Other Leadership /

Please provide in the space below a brief summary of your college career including your involvement in organization, success in your major area, awards/honors, and/or challenges faced and overcome.

Click here to enter text.