H.C SLAMBERG EDUCATIONAL EXCELLENCE SCHOLARSHIP APPLICATION
AWARDED BY THE
NORTH IDAHO COLLEGE FOUNDATION
I000 W. GARDEN AVENUE, COEUR D'ALENE, ID 83814
Deadline: Return this form to your high school counselor by April 1
Student Name Social Security No.
Street No. City State Zip
County of residence Phone No.
Planned College Major High School
Year you will graduate Your current cumulative high school GPA
Rank in graduating class Number of students in your graduating class
For academic verification this form must be signed by a counselor or authorized school official. Without the
proper signature you will not be considered for a scholarship.
Counselor (or authorized school official) Signature
STATEMENT OF PAST ACTIVITIES
Please list any community or high school activities in which you have participated:
STATEMENT OF FINANCIAL NEED
Explain any circumstances you or your family are facing which would influence your family's ability to
help you financially:
STATEMENT OF EDUCATIONAL GOALS
Explain what your educational goals are and how a scholarship would help you attain your goals:
Student Certification: I certify that the information provided on this application is true and correct to the best of my knowledge.