Emerald Coast Business Women Association
Emerald Coast Business Women Association
653 W. 23rd Street
Box 209
Panama City, FL 32405
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Scholarship Application Services
Scholarship Application
EMERALD COAST BUSINESS WOMEN’S ASSOCIATION
DATE______________ SCHOOL____________
STUDENT ID_________
TERM______________
AMOUNT REQUESTED $________
Name______________________________________
ADDRESS_______________________________________________________________________
_______________________________________________________________________________
HOME PHONE__________________________ BUSINESS PHONE________________________
EMAIL ADDRESS: _______________________________________________________________
ARE YOU OVER AGE 23? Yes______ No______ SEX: Male_____ Female____
Marital Status: Single____Married____Widowed____Divorced____Separated____
Do you have dependents? Yes____ No____
If yes, list names and ages: ______________________________________________________________________________
If married, list spouse’s occupation and place of employment:
______________________________________________________________________________
Name of College______________________________________________________
Address_____________________________________________________________
____________________________________________________________________
Are you currently enrolled at this institution? Yes____ No____
If yes, please complete the following:
Field of Study_____________________________________GPA_____________
Part Time_______________Full Time__________________
Total credits required for degree_______________________
Credits already earned toward this degree________________
Anticipated graduation date___________________________
Are you receiving any other financial aid? Yes____ No____
If yes, list sources and amounts:__________________________________
____________________________________________________________
Are you a high school graduate or GED certified? Yes____ No____
Do you have previous college experience? Yes_____ No_____
If yes, fill in the following:
Name of College
Location
Attended From To
Course of Study
Degree obtained
GPA
Are you a U.S. citizen? Yes_____ No_____
If no, are you a legal resident? Yes_____ No_____
Are you currently employed? Yes_____ No_____
If yes, are you employed full time or part time? ____________
List name, address, and phone number of employer: _______________________
__________________________________________________________________
Please give a brief work history covering the past five years.
Name of Company
Location
Position
From
To
Reason for Leaving
Please provide your combined total income. (Including all Sources of Income.)_$__________________
Please explain why you are seeking financial assistance._____________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Please discuss your career goals and objectives.____________________________________________
__________________________________________________________________________________
____________________________________________________________________________________________________________________________________________________________________
Have you participated in any community service activities? Yes_____ No_____
If yes, please list: _____________________________________________________________
__________________________________________________________________________________
Please provide any additional information you wish to be considered. __________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
“Death By Chocolate” is ECBW’s fundraiser to provide scholarships, would you be willing to participate in this event should you receive a scholarship from ECBW? __________________
The CRITERIA used to award scholarships are as follows:
1. The financial need of the student.
2. The student’s future goals/plans.
3. The student must be an Emerald Coast resident (Bay and surrounding counties).
4. The student must be attending a post-secondary school in the Emerald Coast area.
5. The student must have graduated from high school or received a GED.
6. The student must be over the age of twenty-three (23).
7. The ECBW Scholarship Committee will interview candidates under consideration for scholarship.
INSTRUCTIONS:
· Applications should be typed or printed in ink.
· Please complete your answers in the spaces provided. Additional attachments are not necessary and will NOT be considered.
· Application date is determined by Fall & Spring School Schedule--Please check with your school's fincance office--these applications are available there as well.
· Interviews will the next week. Only interviewed candidates will be contacted.
· Fax completed application to:
850-785-2535
Questions?
Please call
Victoria Williams 850-960-0870
For a scholarship application, please email: information@ecbw.net
Copyright Emerald Coast Business Women, Inc.All rights reserved.
Emerald Coast Business Women Association
653 W. 23rd Street
Box 209
Panama City, FL 32405
informat
