Scholarship Application

DEADLINE: RETURN TO YOUR SCHOOL COUNSELOR BY THIRD FRIDAY IN FEBRUARY

Please note that any scholarships awarded will be paid directly to the United States college, university or technical school upon acceptance by this student.

Applicant's Name*

First Last

Gender

Applicant's Email*

Parent's Name

First Last

Home Address*

Street Address City State ZIP Code

Applicant's Phone

Grade Point Average

Class Rank

School

Principal

Counselor

Principal / Counselor Email

SAT Scores

ACT Scores

What accredited United States college, university or technical school do you plan to attend?

Have you been accepted?

Yes
No

What is your anticipated major?

Have you been granted, or do you expect to be granted, other scholarship aid?

Yes
No

If so, give details

What other sources of financial support do you expect to receive? (Include family, employer, part-time job, etc.)

List all school, community and church organizations:

List all honors and awards received in the above organizations:

Student Photo Release Form

Please upload a photo here

Max. file size: 2 MB.

High resolution photos preferred

As parent/guardian of the student named in this application, I hereby grant permission to Colleyville Woman’s Club to use my child’s photograph for publicity purposes in promoting the Colleyville Woman’s Club Youth Volunteer Service Awards in its official publications, or in other promotional print and electronic publications without further consideration, and I acknowledge CWC’s right to crop or treat the photograph at its discretion. Should Colleyville Woman’s Club nominate my child for any award outside of its own organization, including those awards sponsored by the National Points of Light Foundation, Colleyville and Southlake Chambers of Commerce Youth of the Year Awards, or others, I hereby grant permission to Colleyville Woman’s Club to use my child’s photograph with its nominations. I therefore agree to indemnify and hold harmless from any claims the Colleyville Woman’s Club, its members and members of the Youth Recognition Service Awards committee.

Parent's Signature

Applicant's Signature

DEADLINE: RETURN TO YOUR SCHOOL COUNSELOR BY THIRD FRIDAY IN FEBRUARY. You will receive a confirmation email including all fields of this application. From there you may either print the form for submission to your counselor or forward that email to your counselor. Please check with your counselor for preferred submission format.

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Scholarship Application

Student Photo Release Form

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