ICFNC Advisory Board Corporate Scholarship

COLLEGE NAME: *

STUDENT NAME: *

DATE OF BIRTH

STUDENT MAJOR: *

CUMULATIVE GPA *

GPA: (select one)

High School

College

2023-24 CLASS: (select one) *

Freshman

Sophomore

Junior

Senior

ARE YOU A FIRST GENERATION STUDENT?

Yes

No

EXPECTED GRADUATION DATE:

GENDER:

Male

Female

ETHNICITY: (select one)

IF OTHER, SPECIFY:

STUDENT PERMANENT ADDRESS *

STUDENT PERMANENT ADDRESS

City

State/Province

Zip/Postal

Country

NC COUNTY: *

STUDENT PHONE: *

STUDENT EMAIL: *

FORM COMPLETED BY (must be a financial aid staff member): *

PHONE NUMBER OF FORM COMPLETER: *

The student understands that if s/he is selected for this scholarship, his/her name, information, and/or picture may be used in future promotional materials in relation to this program.

Has this been discussed with the student?

Does the student agree?

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