Fibre Federal Credit Union - PDF

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                                                   Applicants Must Be a Credit Union Member
                                                   Most Recent School Transcripts or Equivilent
                                                   One Current Letter of Recommendation
PO Box 1234, Longview, WA 98632
Phone (360) 423-8750
                      Fibre Federal Credit Union
                  2010/2011 Scholarship Application
  1.   Name

       Phone                                     Message Phone

  2.   High School
       Graduation Date
       Grade Point Average for the last 3 years.

  3.   List school activities in which you are interested in.

  4.   List any special interests outside of school (i.e. volunteer work, hobbies, etc.)

  5.   Name and location of the college you plan to attend.

       Name of School                                      Location

  6.   Type of housing.
           Dormitory              Relative          Apartment         Other

  7.   College standing at the time of scholarship use.
            Freshman          Sophomore            Junior              Senior              Other

  8.   College Major
       Career Choice

                                             Page 1 of 3                          January 2010
9.   List colleges you have attended (including present), and credits earned.
                   College                    Credit Hours              Date                Year
                                               Completed              From / To           Graduated

10. Income source (if applicable)
    Applicant Occupation
    Employer                                                    Hours per Week

     Spouse Name                                         Occupation

     Father’s Name                                       Occupation
     Mother’s Name                                       Occupation

11. List all employment held during the past two years. Include college work study.
                Employer                       Nature of Work                     Date From / To

12. Number of other children in family attending -
    Grade School          Middle School            High School         College
    Community College             Vocational School         University

13. Annual income and expense to attend one year at college of choice.
        College Expenses (i.e. tuition, books, fees)         $
        Other (i.e. room, board, transporation               $
        Unusual Expenses (describe below)                    $

                                              Total Expenses $
     Funds dedicated to College Expenses
         Personal Funds (i.e. savings, employment)                $
         Earnings while in college (i.e. work study)              $
         Parental Support / Spousal Support                       $
         Scholarships                                             $

                                      Page 2 of 3                                 January 2010
              Welfare Benefits                                     $
              Alimony / Child Support                              $
              Other Income Source                                  $
                                                      Total Income $
                      Financial need for 2010/2011 school year. $

14. List the names of two people, not related to you, who would personally recommend
    you for this scholarship.
             Name                                       Home Phone       Work Phone
             Name                                       Home Phone       Work Phone

15. Applicant Statement.
I am applying for the Fibre Federal Credit Union scholarship because…

I certify that, to the best of my knowledge, the information contained in this application is
correct and complete. I authorize Fibre Federal Credit Union to verify the given information.

Applicant Signature                              Date

You are welcome to provide any additional information on a separate sheet of paper that
would aid the Scholarship Committee in making the award.
Scholarship Applications accepted January 1, 2010 through March 31, 2010.

                                        Page 3 of 3                           January 2010

Description: Fibre Federal Credit Union document sample