Women's club of coconut creek

WOMEN'S CLUB OF COCONUT CREEK

2009 SCHOLARSHIP APPLICATION

Name__________________________________________________________ Age _______

Last First Middle
Address________________________________________________________ Sex______
Telephone Number ______________________________ Soc. Sec. # _________________

Father's Name _____________________________________________ Living? _________

Mother's Name _____________________________________________ Living? _________

Guardian’s Name (if applicable)_________________________________________________

Occupation of Father ___________________Occupation of Mother _____________________
Number of family members living at home____ Ages of brothers and sisters__________________

Number of family members currently attending college__________

Please check the blank representing your family's total income for the past year:

Under $30,000____ $31 - $50,000 ____ $51 - $70,000____ Over $70,000 ____

What is your current GPA? weighted__________________ unweighted __________________
Highest total SAT score__________________ Highest total ACT score____________________
How many total hours of community service have your accumulated? _______________________
Do you have a job? __________ Where? _________________________________________

How many hours a week do you work? ________

What college or vocational school have you selected to attend?

_______________________________________________________________________

Why have you selected this school?________________________________________________

_______________________________________________________________________

Have you been accepted?______ What is your intended major?___________________________
What percent of your college expenses will be paid by your parents?_______________________
List all financial aid, scholarships or grants for which you have applied.

_______________________________________________________________________

_______________________________________________________________________
Do you have any relatives in the Women’s Club of Coconut Creek?_____

If so, please list their names.___________________________________________________

I am a resident of Coconut Creek. The statements I have made in this application are true and accurate to the best of my knowledge. I understand that if I receive a scholarship award, it will be available for the Fall 2009 term and must be used by December 31, 2009.

_______________ ______________________________________

Date Signature of Applicant