Personal Information
Name *
Name
Address *
Address
Phone *
Phone
Gender
Academic Information
Entering Gillette College as: *
Recent High School Attended:
Years Attended
Cumulative GPA
Recent College Attended
Programs of Study/ Areas of Interest
Financial Information
Must complete FASFA for Eligible Amount
Must complete FASFA for Eligible Amount
Emergency Contact Information
I understand that proof of acceptance of current student enrollment from Gillette College is required prior to receipt of funding. I understand if I do not complete the full school year, my scholarship will be revoked and I will be responsible for all costs incurred.
I hereby affirm all the above stated information provided by me is true and correct to the best of my knowledge. I hereby understand, if I am chosen as a scholarship winner, according to Gillette College's Enrollment policy, I must provide evidence of enrollment/registration at Gillette College before scholarship funds can be awarded.
The deadline for this application to be received by the Energy City Voices is - June 1, 2015 -