Scholarship Application -

Social Security Number*

First Name*

Middle Name

Last Name*

Maiden or Other Name

Street Address*

Address Line 2

City*

State / Province*

Enter your state / province

Zip / Postal Code*

County*

Enter your county

Country*

Telephone (with Area Code)

Email

Sex (M/F)

How do you describe yourself?

Are you a veteran?

Major Area of Study at State Tech

What scholarship(s) are you applying for?

Please read guidelines for the respective scholarship(s) you are applying for and include all information needed on this application.

What other financial aid have you applied for?

Have you held a full-time, part-time, or summer job?

Will you be working while attending State Tech?

Is your job related to the technical field you are going to study?

Personal Goal Statement

Submit a statement relative to your educational and vocational goals. You might include what your plans and aspirations are for the future and what values you hold to be important to your development. Also, address why you should be awarded the scholarship.

Please list the name and email of your High School Counselor

Counselor Name

Counselor Email

Have you participated in any school-related activities or organizations?

Please select each school-related activity or organization you have participated in

Please list other school-related activities or organizations you have participated in

Please select each athletic activity you have been involved in

Did you hold an office or position in any of your school-related activities or organizations?

School Related Organizations / Activities - Office / Position

Please list below all school-related activities and organizations in which you have held an office or position, including office or position held.

Organization / Activity	Office / Position

Have you received any school-related awards or honors?

Yes
No

Awards / Honors

Please list below all awards or honors you have received in school-related activities or organizations

Organization / Activity	Award / Honor

Have you participated in any community activities or organizations?

Please select each community-related activity or organization you have participated in

Please list other community-related activities or organizations you have participated in

Did you hold an office or position in any of your community-related activities or organizations?

Community-Related Organizations / Activities - Office / Position

Please list below all community-related activities and organizations in which you have held an office or position, including office or position held.

Organization / Activity	Office / Position

Have you received any awards or honors through your community activities?

Yes
No

Awards / Honors

Please list below all awards or honors you have received in school-related activities or organizations

Organization / Activity	Award / Honor

Additional Information

Please provide any additional information related to scholarship criteria that you want the selection committee to consider when reviewing your application. You may want to address your financial need and/or any special circumstances.

Character Reference #1

First Name

Last Name

Company Name

Job Title

Address

Street Address Address Line 2 City State ZIP Code

Phone (with Area Code)

Email

Character Reference #2

First Name

Last Name

Company Name

Job Title

Address

Street Address Address Line 2 City State ZIP Code

Phone (with Area Code)

Email

Copies of your Test Scores, High School transcript, and college transcript (if applicable) are required to complete our application. Any items not already submitted to the college should be sent via fax 573.897.4656 or mailed to the State Tech Scholarship Committee, One Technology Drive, Linn, MO 65051.

Please Note: In order to continue receiving financial aid awards, all recipients receiving financial aid (including scholarships) must maintain a minimum grade point average (GPA) of (2.0) and a continued student status of full-time. Some scholarships require a higher GPA, please refer to scholarship guidelines.

By submitting this application, I certify that the information provided is true. I have read and understand the guidelines of the scholarships at State Technical College of Missouri and agree to the terms stated. I give my permission to let any scholarship committee review my high school transcript, test scores, and college transcript (if applicable) for awarding the scholarships for which I’m eligible. This will remain in effect until I have graduated from State Technical College of Missouri or until I revoke this permission in writing.

Name

This field is for validation purposes and should be left unchanged.

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Scholarship Application