TPBA Family Scholarship Application

Scholarships will be taken January – June. Scholarships will be awarded in August.

Criteria:

  • US Citizen or Permanent Resident
  • High School Diploma or Equivalent
  • Full-time student at Sophomore level (or higher) at an accredited two or four year college; Part time will be considered on a case-by-case basis
  • Minimum G.P.A. of 2.5
  • Child or Dependent of TPBA member

TPBA Member Name______

First Name______

Middle Name______

Last Name______

Suffix (e.g. Jr., III) ______

Planned Major______

Current Mailing Address:

Street Address ______

City/State/Zip ______

Family Information:

Father’s Name ______

Street Address ______

City/State/Zip ______

Mother’s Name ______

Street Address ______

City/State/Zip ______

Step-Parent (if applicable) ______

Street Address ______

City/State/Zip ______

College or Universities Attending or Attended:

College or Universityname ______

City/State ______

Date Entered ______

Date Departed ______

Major ______

College or Universityname ______

City/State ______

Date Entered ______

Date Departed ______

Major ______

College or Universityname ______

City/State ______

Date Entered ______

Date Departed ______

Major ______

College or Universityname ______

City/State ______

Date Entered ______

Date Departed ______

Major ______

College or Universityname ______

City/State ______

Date Entered ______

Date Departed ______

Major ______

*If you would like to add another college or university, please attach on a separate sheet.

Awards, Special Honors, and Distinctions:

Award/Honor/Distinction ______

Year ______

Award/Honor/Distinction ______

Year ______

Award/Honor/Distinction ______

Year ______

Award/Honor/Distinction ______

Year ______

Employment, Internships, and summer activities:

Employer ______

Job Title ______

From (MM/YYYY) ______

To (MM/YYYY) ______

Employment, Internships, and summeractivities:

Employer ______

Job Title ______

From (MM/YYYY) ______

To (MM/YYYY) ______

Employment, Internships, and summeractivities:

Employer ______

Job Title ______

From (MM/YYYY) ______

To (MM/YYYY) ______

*If you would like to add another college or university, please attach on a separate sheet.

Extracurricular Activities:

Organization/Activity or Description of

Activity ______

Year(s) Involved ______

Leadership Positions Held______

Organization/Activity or Description of

Activity ______

Year(s) Involved ______

Leadership Positions Held______

Organization/Activity or Description of

Activity ______

Year(s) Involved ______

Leadership Positions Held______

*If you would like to add another college or university, please attach on a separate sheet.

Short Answer Questions:

  1. Why is a scholarship important to you? ______

______

______

______

  1. List any other scholarships you have received this academic year.______

______

______

______

  1. Why have you chosen your academic major(s)?

______

______

______

______

  1. What are some of your life goals and objectives?

______

______

______

______

  1. If any, indicate special circumstances that affect your family’s ability to fund your

College expenses. ______

______

______

______

  1. If there is any other information you would like to provide, please do so.

______

______

______

______

______

______