First Citizens' Charitable Foundation Scholarship Application

Date

Available Scholarships and Information, Please Review Flyer Below:

For which scholarship are you applying for?

Both Scholarships Barbara Whitehead-Silva Scholarship First Citizens' Charitable Foundation Scholarship

Student Name *

First Name Last Name

Phone Number *

Area Code Phone Number

Email *

example@example.com

Are you currently living at home?

YES NO

Mailing Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Who is a First Citizens' Federal Credit Union Member: *

Applicant Parent/Guardian

Applicant Name

First Name Last Name

Parent/Guardian Name

First Name Last Name

Name of Account Holder *

Address of Account Holder

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Extracurricular Activities and Community Service:

Write a brief paragraph or list activities

List names of sibling currently attending college and the college they attend:

Sibling 1

Sibling 2

Sibling 3

Sibling 4

College or university that you plan to attend:

Have you been accepted to attend this college or university?

YES NO

During the school year, will you be:

Living on campus Commuting

Do you have a job?

YES NO

Estimated student annual income:

Estimated TOTAL household annual income:

Tuition expense for college or university you will be attending

Room and Board

Books, Supplies, Fees

Transportation

Other

Estimated TOTAL Expenses

Savings, Checking Accounts (include 529 College Savings Plan account)

Employment

Aid from Parents and Family

Aid from College

Aid from Others

Estimated TOTAL Funds

Please Upload High School Academic Transcript *

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Please upload a Letter of Recommendation from someone other than a parent/guardian who has experience working with you through school, school activity, job, or community involvement *

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Please upload a type written single spaced essay (500-600 words) that answers the following question: Why did I choose my major field of study and how will it apply to my career goals? *

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Release: If awarded a First Citizens’ Charitable Foundation Scholarship, by signing this application, I hereby give First Citizens’ Federal Credit Union the absolute right and permission to copyright, publish, and/or otherwise use photographic portraits and/or pictures of me. This includes material in which I may be included in whole or in part, and also pertains to such material whether it is used in conjunction with my own name or with a fictitious name. This includes permission for use in advertising, editorial, trade, display, and/or electronic media, or for any other lawful purpose whatsoever. I hereby waive any right to inspect and/or approve the finished product or the advertising copy, voice-over, or audio that may be used in conjunction therewith and discharge and agree to release First Citizens’ Charitable Foundation and it’s parent company First Citizens’ Federal Credit Union from further liability.

Expiration: Award money from the First Citizens’ Charitable Foundation Scholarships must be applied towards university or college Winter/Spring semesters directly following the award date. Scholarships not processed during the Fall/Winter or Spring/Summer semester that directly follows the award date will be considered void. First Citizens’ requires your semester class registration and bill in order process your scholarship check. Check will be made out in the name of the student and college then mailed to the students home.

Student Signature *

Parent/Guardian Signature *

Please verify that you are human *

Estimated Expenses

Estimated Funds Available