The Nicole Marie mccarty Scholarship by wuyunyi

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									                    The Nicole Marie McCarty Scholarship
                                       APPLICATION
Please Print
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1. Full name of 12 grade applicant: ____________________________________________

2. Full address of applicant: ___________________________________________________

3. Years in attendance at Centreville H.S.: _______________________________________

4. Current seventh semester GPA with counselor signature: _________________________

5. List the names of the colleges/universities to which you have been accepted:

________________________________ _______________________________________
________________________________ _______________________________________
________________________________ _______________________________________

6. List the names of the honor societies of which you are a member. Indicate the years of
    membership and have the sponsor verify (initial)

          Honor Society             Years of Membership                Sponsor Verification
____________________________________ __________________                _________________
____________________________________ __________________                _________________
____________________________________ __________________                _________________
____________________________________ __________________                _________________

7. List the names of the school-sponsored clubs or organizations in which you have participated.
    Indicate the years of membership and have the sponsor verify (initial):

      Club/Organization                        Years of Membership     Sponsor Verification
_____________________________________          __________________      _________________
_____________________________________          __________________      _________________
_____________________________________          __________________      _________________

8. On a separate sheet of paper write a description of how you have demonstrated leadership,
    citizenship, or service to the school or the community. You should also tell us how you would
    benefit from this scholarship. Your comments should be typed and should not exceed 250
    words.

Place the completed application and your typed response to #8 in an envelope and deliver to
the Guidance Office no later than May of this year.

								
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