5101 North Classen, Suite 500
Oklahoma City, OK 73118
Phone: (405) 416-2284
FAX: (405) 416-2666
2009-2010 Scholarship Application Information
• First Fidelity Bank offers one, $1,000, freshman year scholarship for undergraduate students
graduating from high school in the spring of 2009.
• Scholarships are for students attending The University of Oklahoma or Oklahoma State University.
• Completed applications (with attachments) can be sent via mail or fax to the Scholarship Committee,
First Fidelity Bank, N.A., P.O. Box 32282, Oklahoma City, OK 73123 or Fax to, (405) 416-2666.
• Please contact Steve Adamo, First Fidelity Bank, with questions at firstname.lastname@example.org or
• Applicants must be a High School graduate attending the University of Oklahoma or Oklahoma
• Applications must be received at First Fidelity Bank by March 31, 2009 to be eligible for
• The maximum time for using the scholarship will be 1 year from the time of the award.
• Please obtain an unofficial transcript from your high school.
• Transcripts must list each course taken, grades, grade point average, and ACT or SAT scores.
• Applications will be reviewed by the First Fidelity Bank Scholarships Committee.
• Recipients are determined by those best meeting the criteria set annually by the committee.
• The Scholarships Committee uses the information received from applications to make such
• Notification will be sent to the permanent address of all applicants by April 30, 2009.
• Payment will be in the form of a $500 tuition offset each semester, for a total of $1,000, by the
Final Check List
Complete application form with signature
All materials received by First Fidelity Bank by March 31, 2009
Date Recieved _____________________________
Current High School________________________
I Plan to Attend:
The University of Oklahoma
Oklahoma State University
Name (First, Middle, Last): _____________________________________________________
Permanent Address: _________________________________________________________
City: _____________________________ State: ________ Zip: ______________________
Permanent Phone: _________________ Email: ___________________________________
Date of Birth (MM/DD/YYYY): _____________ Social Security Number: ___________________
Which group best describes you? (This question is optional)
Caucasian African-American Hispanic Asian or Pacific Islander
American Indian or Alaskan Native Other
High School GPA: ________________ Cumulative GPA (as of December 2008)
Grade Point Basis: ________________
Class Rank as of December 2008 ____________ Number in Graduating Class ___________
ACT Composite: _____________________ SAT Score Total: ________________________
Please attach an unofficial transcript from your high school to this application.
PROJECTED FINANCIAL INFORMATION FOR 2009-2010 ACADEMIC YEAR
Employment $__________ Tuition & Fees $__________
Loans $__________ Room & Board $__________
Scholarships/Awards/Grants $__________ Books & Supplies $__________
From Your Family $__________ Other Expenses $__________
Other Income $__________
TOTAL INCOME $__________ TOTAL EXPENDITURES $__________
I certify the information I have provided on this application form and any additional material are complete, accurate, and true
to the best of my knowledge. I understand any false statements made herein will void this application and I will be ineligible
for a scholarship from First Fidelity Bank. I understand this application becomes the property of First Fidelity Bank.
Name (First, Middle, Last):
(List most recent activity first. Attach additional information if needed.)
Organization Office/Position Held From To
ACADEMIC HONORS / OTHER AWARDS
(List most recent honor or award first. Attach additional information if needed.)
Honor / Award Received (MM/YY)
(List current position first. Attach additional information if needed.)
Organization Position Held From To
Please include below a brief handwritten statement. The subject is your choice but may include a description of any special
circumstances you would like us to consider. The Scholarship Committee can consider demonstrated disadvantages or
special circumstances when making awards.
With the submission of this application, I, ____________________________________ hereby give the University of
Oklahoma or Oklahoma State University permission to release all personally identifiable information related to this scholarship
to the potential scholarship donor and permission to release my academic records to the donor of my scholarship as long
as I am applying for or receiving assistance.
Date __________________ Applicant Signature __________________________________
High School Counselor Certification: I certify that the test scores and high school rankings in this
application are accurate.
Date: __________________ Counselor Name: ___________________________________
High School Counselor Signature ___________________________________