Scholarship Application Form

Note: If necessary, please submit an LFCC application for admission to the Admissions Office before you submit your online scholarship application packet. The application and a new student checklist are available online at http://www.lfcc.edu/Academics/StepbyStep.shtm

Items marked with an asterisk (*) are required

The information icon () denotes that there is an important note about the preceding form field.

Contact information:

First Name:*
Middle Initial:*
Last Name:*
LFCC Student I.D. Number:*

The student I.D. number is exactly seven characters.

If you do not know your student I.D. number, you can find it by visiting MyLFCC and clicking on the link next to "New to your college?"

Birthday:*

Please format the birthday the following way: MM/DD/YYYY
for example - 01/27/1985

Residence Address

Street:*

City:*

State:* Zip:*

Locality:*

Mailing Address

Street:

City:

State: Zip:

Telephone Number:
Cell Phone Number:
E-mail Address:*
Confirm E-mail Address:

Background Information:

Name of High School Attended:*
If "other", please specify:
Year of completion:*

Employer and Title/Position (former, if retired):

Please note: This information is required for some organization-sponsored scholarships.

Please list the name of your parents’ employer:

Please note: This information is required for some organization-sponsored scholarships.

If you want to be considered for the Cultural Diversity Scholarship, please provide your race or national origin: Have you applied for financial aid?*

If “no,” apply online at www.fafsa.ed.gov

For the semester you are seeking financial aid, do you plan to attend LFCC:*

Please note: Full-time students are those enrolled in at least 12 credits during a semester. Part-time students are those enrolled in fewer than 12 credits during a semester.

Program of study for the semester you are seeking financial aid:* Primary LFCC location you are attending:* Do you plan to transfer to a four-year institution upon graduation from LFCC?* If yes, please provide the name of the institution: If "other", please specify: Please select the statement that best describes your mother's level of higher education:
My mother…* Please select the statement that best describes your father's level of higher education:
My father…* Are you a full-time employee at LFCC?* Are you an immediate family member of a LFCC employee?* If "yes", please provide employee name and relation:

Eligibility Requirements

Essays

In the box below, please submit a one-page essay (between 3,000 and 4,000 characters) discussing your goals and purposes to be served by a scholarship, educational objectives, any extracurricular activities/life experiences (e.g. athletics, scouts, community service) and how a scholarship will benefit you financially. Please do not include your LFCC student I.D. number, name or Social Security number in the essay.* If you meet the requirements and would like to be considered for the Commonwealth Legacy Scholarship Program, please answer the following questions in a second one-page typed essay (between 3,000 and 4,000 characters):

What does community college education mean to you, and how would you promote it?
How would you mentor future scholars? What would be your message to them?
Describe two areas in which you are interested in developing your leadership skills.

Acceptance of terms

Please check each box below to certify that the information you have provided in this application is true and complete to the best of your knowledge.*

I authorize the Admissions and Records Office and the Financial Aid Office to release information about me to the scholarship committee and appropriate staff.

I agree to appear before the scholarship committee for a personal interview if asked.

If I am selected for a scholarship, I authorize the release of biographical information for use in publicity related to the scholarship program. I understand that anything I write as part of my scholarship application may be shared with the scholarship donor and/or used for publicity in College and LFCC Educational Foundation Inc. written materials, online information and media opportunities.

I further agree that I will notify the Financial Aid Office of any changes that would affect my eligibility for any scholarship award (changing my program of study and auditing, dropping and withdrawing from classes, for example).

I understand that I will be asked to serve as an ambassador or representative of LFCC at events during the year.

If selected to receive a scholarship, I understand that I will be required to write a thank-you note to the scholarship’s donor and meet with the donor at appropriate functions.

I understand that my contact information will be entered into the Foundation's database and that I may be contacted in the future by the Foundation.

If you need assistance completing this application, please contact the Financial Aid Office at 540-868-7130 or finaid@lfcc.edu.