Date:

Student ID# (If applicable):

First Name:

Last Name:

Middle Name:

Address:

Zip:

Note: The City and State will auto-populate from your zip code entry.

City:

State:

Phone (Daytime):

Phone (Evening):

Email:

Date of Birth:

For which program are you seeking a scholarship? 

Program Start Date:

Write a brief explanation of your goals:

Please check all that apply in regard to this request:

Describe any relevant information in support of this request:

By submitting this application, I authorize Cecil College to release information pertaining to my academic records, including grades, GPA, program, financial aid, scholarship, loan information/FAFSA data, and enrollment status, along with information contained in this application to the Program Director, General Scholarship Committee and/or reviewers to review in considering my application. I certify that all statements and information on my application are complete and true. If any of the information I have provided is determined to be inaccurate, I understand that this may result in a loss of the scholarship. Also, I understand that Cecil College Foundation scholarships may require a specific GPA or require good standing in my program, and that I meet the criteria for the scholarship I receive, remain enrolled in the program or be enrolled in a specified number of credits each semester, as applicable. Not meeting the required criteria will be cause for my scholarship to be revoked. I certify that the work in this application is my own. I authorize Cecil College Foundation to share the content of my application with any donors, faculty and staff involved in awarding this scholarship. If awarded a scholarship I agree to permit my name and photograph to be released for publication to the media and donors, I give Cecil College unrestricted permission to use, reuse, publish and republish my image in any media form for the purpose of promoting Cecil College, which may include advertising, promotion and marketing. I agree that the images may be combined with other images, text and graphics, and may be cropped, altered or modified. Submitting a scholarship application does not guarantee a scholarship. The Financial Aid office and the Cecil College Foundation have the right to modify my award at any time due to changes in my eligibility, enrollment status, an over award of funding or receipt of any funds not included in my original award package.