ROGERS COMMUNITY BASED SCHOLARSHIP APPLICATION

2017-2018

DEADLINE DATE: WEDNESDAY, NOVEMBER 8, 2017 4:00 PM

SIGNATURE PAGE

Name:

First MiddleLast

PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY. Your signature and the signature of a parent or guardian will indicate that you have read and understood this information. Signatures of BOTH parent or guardian AND student are necessary for application to be valid and complete.

Student Certification:

I certify that, to the best of my knowledge, the information on this application is accurate and complete and that the signatures on this page are valid. I understand that should either signature be found invalid, my application will be removed from consideration for any community based scholarships. I also certify that both my parent or guardian and I understand that the information contained in this application will be made available only to the donors that I request it be given to, including all information on my transcript.

Student’s Signature (Required) ______

Statement of Parent or Guardian: (REQUIRED)

Please share why you feel your son or daughter should receive a community scholarship. You may include any information regarding your financial situation or family circumstances that you are comfortable sharing with donors. This statement will be kept as confidential as possible. However, your signature and that of your child will indicate your permission for the release of any information on this application to those who are awarding those scholarships your student applies for. If you need additional space, please attach it to this page.

Parent or Guardian’s Signature (Required) ______

Parent or Guardian’s Email Address (Optional)

IMPORTANT INFORMATION:

This application will be kept on file in the Scholarship Office and NOT given to any scholarship donors until such time as your student informs the Scholarship Coordinator of the specific scholarship(s) he/ she would like to be considered for.

Check the scholarship list weekly. New scholarships are added each week. When your student sees a community scholarship that he/she qualifies for and is interested in applying, he/she MUST visit the scholarship office to submit his valid application for that scholarship. Failure to notify the scholarship coordinator of each scholarship the student would like to apply for results in the student not being considered for that community scholarship. See your Scholarship Coordinator for more information.