Thank you for your interest in the EICA’s Scholarship Award Name in full:__________________________________________________________________
Home Address: ________________________________________________________________
Home Telephone: __________________ Date of Birth:__________________ Parent or Guardian’s Name: _____________________________________________________ HIGH SCHOOL RECORD Name of High School: ______________________________ Grade Point Average:________
Dates of Attendance: from___________________ to ______________________ Graduation Date: __________________ COLLEGE PLACEMENT TESTS Composite SAT score(s) _______________ ACT score ___________________ COLLEGE, UNIVERSITY, TECHNICAL OR TRADE SCHOOL PLANS School Name: _________________________________________________________________ Address: ______________________________________________________________________ Date of Acceptance: __________________ NOTE: WE MUST HAVE A COPY OF THE
If you are still undecided please list the schools to which you have applied: First Choice: _____________________________________________ Accepted? Yes No Second Choice: __________________________________________ Accepted? Yes No Continue on back of this page if necessary. Please list other scholarships or grants for which you have applied: Scholarship Name: ______________________________________ Amount: $____________ Scholarship Name: ______________________________________ Amount: $____________ Scholarship Name: ______________________________________ Amount: $____________
PERSONAL STATEMENT RECOMMENDATIONS High School Principal’s Name: __________________________________________________ Telephone: ____________________________________ Guidance Counselor’s Name: ____________________________________________________ Telephone: ____________________________________ High School Teacher’s Name: ____________________________________________________ Telephone: ____________________________________ CERTIFICATION: I certify that all the statements made in this application are true, complete and correct to the best of my knowledge. Further, that I have no objection to the above information being made available to the members of The Edisto Island Community Association Scholarship. Applicant’s Signature: __________________________________________________Date ____________________ Parent’s or Guardian’s Signature: __________________________________________________Date ____________________
REMINDER
THE FOLLOWING DOCUMENTS COMPRISE A COMPLETE APPLICATION:
IF YOU DO NOT RECEIVE IMMEDIATE NOTIFICATION ACKNOWLEDGING JIMMY JONES 869-1979 or FRANCINE MORRISON 869-3161
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