South
Shore Foundation Academic Scholarship Application
| Only
students who are attending a South Shore area high school
are eligible for this $1,000 scholarship. This includes
students who are graduating or have graduated from Flippin,
Yellville-Summit, Lead Hill, Omaha, Bruno-Pyatt and Bergman.
The $1,000 scholarship is renewable for up to four years
when scholarship holders retain a 3.0 GPA and remain enrolled
full time (minimum of 12 hours per semester or quarter)
at an Arkansas college or university. |
Deadline:
March 31st
Turn in your application to your High School counselor. High
School counselors must notify the South Shore Foundation of
the winner by April 15th.
Transcript Deadline: July 31st (for renewing
scholarship recipients) Send complete transcripts to the South
Shore Foundation c/o Deanna Sullivan/NATCO P.O. Box 209 Flippin,
AR 72634.
| Scholarship
Application - Graduating Seniors and/or
Students Renewing Scholarships |
Student
Name: ________________________________ Parents Name:
_______________________________
| _______
- _______ - _______ |
________ |
________ / ________ / _________ |
| Social
Security Number |
Age |
Date
of Birth |
Permanent
Address (Parents or Student): ______________________________________________________
City: _____________________________ State:
________________ Zip: ________________
State
& County of Legal Residence: __________________________________________________
| ___________________ |
___________________ |
| Home
Phone # |
Cell
Phone # |
Today's
Date: ________ / ________ / _________ South
Shore High School:___________________________
College
Expected to Attend:
_____________________________________________________________________________
College Address: _______________________________________________________________
City: _____________________________ State: __________________
Zip: _______________
Major: ______________________________________________________________________
Expected Date of Graduation: _______________
High School
College
Estimated cost per semester: Tuition & Fees
_________________
Room & Board ___________________
_______________________ ___________ ___________________ ____________
High School Grade Point ACT
Scores SAT
Composite Score
College GPA
Average (From Transcript) (Highest)
(Highest)
Seniors:
*Enclose a Current Official High School Transcript
& ACT/SAT Scores.
*Enclose Proof of Admission to College,
if Available.
*Students
Renewing Scholarships: enclose a current complete college transcript.
Will
you be employed while attending college?: _____________
Employer:
_____________________________________________________
Phone #: ___________________
Number of
hours worked per week: _________________
| Extra
Curricular Achievements |
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
Have
you received or are you going to receive any other scholarships?
yes_____ no_____
Please list with $ amounts.(Do not include loans or work study
information)
| __________________________________ |
________________________ |
$_________________ |
| Title
of Scholarship |
Source
of Scholarship |
Amount/year |
| __________________________________ |
________________________ |
$_________________ |
| Title
of Scholarship |
Source
of Scholarship |
Amount/year |
| __________________________________ |
________________________ |
$_________________ |
| Title
of Scholarship |
Source
of Scholarship |
Amount/year |
Write
a letter from yourself stating your need for this scholarship,
plans for your education, and
your future career.
The
South Shore Academic Scholarship Financial Statement
The
Financial Statement of (parent's or guardian name or student's
name):_____________________________
Address:
__________________________________________________________________________
Telephone
Numbers - Home: __________________________ Cell:
__________________________
RE:
Application of: __________________________________________________________________
(Name
of Student)
My.SouthShore.com