Scholarship Application

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APPLICATION DEADLINE: Friday, March 29th, 2024 at 5:00 P.M. This is NOT a postmark deadline.

Please click below for a complete description and full eligibility requirements of all the listed scholarships before choosing the scholarship(s) you wish to apply. Additional Scholarship information and downloadable applications are also available on our website.

CLICK HERE: for Scholarship Application PDF

CLICK HERE: For Information Regarding Scholarship Descriptions and Eligibility Requirements

Student Name(Required)

First Last

I am applying for the (mark all boxes that apply):(Required)

Eric Charles Bowyer Memorial Fund

Charles L. Lauck, Jr. Memorial Scholarship

Jacqueline Corbin Pleasants Democratic Scholarship

George C. Marshall Chapter of MOAA Scholarship

Lexington High School Scholarship

Blair Family Scholarship

The Pastor Fred Scholarship

The Margaret Gresham/Covington Woman's Club of GFWC Scholarship

Stonewall Jackson Ladies Auxiliary Scholarship

Jaclyn’s Hope Scholarship

Application Checklist (For Applicant Use)

Completed Application

Current Resume

Official Transcripts

3 Letters of Recommendation in envelopes sealed by the writer

Copy of most recent federal income tax return(s) or Student Aid Report

Essay (if required)

Please complete each of the items listed above and mail to: CFRBA PO Box 20 Lexington VA 24450

Please complete only ONE application

Please complete only ONE application form!

Many of the scholarships have a specific purpose and selection criteria.

DO NOT apply for any scholarship(s) for which you do not qualify.

ALL APPLICANTS: Complete all pages of the application and any supplemental forms/essays as required.

If you are a high school student, make sure a School Official/Guidance Counselor submits an official high school transcript.
If you have graduated from high school or have never been enrolled in college, you must attach a copy of your high school transcript.
If you are currently enrolled in college, you must attach a copy of your official college transcript. If you have only been enrolled for one semester, please submit whatever school record available.
If it is the policy of the school you attend not to give official school records to students, then these records may come directly from the school providing they arrive before the deadline. School Records not received by the deadline will be considered incomplete and will not be reviewed.
You must have three (3) letters of recommendation. ALL recommendations should be given to you by the writer in a sealed envelope. You should send the envelopes to COMMUNITY FOUNDATION FOR ROCKBRIDGE, BATH AND ALLEGHANY unopened. Do not send separately. Recommendation letters that are sent under separate cover must arrive by the deadline or your application will be considered incomplete and will not be reviewed.
Website generated transcripts or faxed transcripts will not be accepted.

PLEASE BE SURE THE FOLLOWING MATERIALS ACCOMPANY YOUR APPLICATION:

Completed Application. DO NOT STAPLE YOUR APPLICATION OR ITS ATTACHMENTS.
Current Resume. Please include your academic/scholastic activities (clubs, student government, National Honor Society, etc), sports, community activities (civic activities, clubs, volunteer work, faith activities, etc), number of years you have participated and your leadership position, letters earned, awards received, and recognitions. Additionally, please include your work experience such as self-employment, employer name, nature of work, supervisory positions held, and dates employed. (Maximum 2 page)
Most recent high school transcript and/or college transcript.
Three (3) letters of recommendations in envelopes sealed by the writer.
All essay(s) noted on page 2.

***Incomplete applications and applications that arrive after the deadline will not be reviewed.***

APPLICANT STATEMENT: I certify that I have read and understand the scholarship application instructions and requirements stated above.

Applicant Signature(Required)

Digital Signature

Date(Required)

MM slash DD slash YYYY

PERSONAL INFORMATION

Name(Required)

First Last

Mailing Address(Required)

Street Address Address Line 2 City State ZIP Code

Permanent Address(Required)

Street Address Address Line 2 City State ZIP Code

Permanent Address (if different from above) Correspondence will be sent to your permanent address.

Email(Required)

Phone(Required)

Include Area Code

Cell Phone

Include Area Code

Work Phone

Include Area Code

Birthdate (mm/dd/yyyy)(Required)

Social Security (Last 4 digits)(Required)

Gender(Required)

Male

Female

Education(Required)

G.E.D. Graduate

High School Senior

High School Graduate, Never Enrolled in College

Undergraduate Student (ages 17-24)

Undergraduate Student (ages 25+)

Graduate Student

High School(Required)

Graduation Date (mm/yyyy)(Required)

City(Required)

State(Required)

Please list educational institutions you have attended as well as workshops, seminars, etc. Provide only post-high school information. Begin with the most current information.

Name of Institution

# of Credit Hours

GPA

Dates Attended

Degree Granted

MARK APPROPRIATE CHOICE - Level you will be entering in college:(Required)

Freshman

Sophomore

Junior

Senior

Graduate

Other

List in order of your preference the colleges or institutions to which you have applied and complete the additional information.

Name of College or Institution(Required)

Type of Institution(Required)

(2 yr./4 yr./voc./tech./seminary/other)

Accepted?(Required)

Yes

Pending

COST(Required)

(Tuition, Room & Board)

Degree you will be pursuing(Required)

Graduate

Other

Field of study(Required)

Will you be enrolled:(Required)

Full-time (12 or more hours)

Part-time (6-11 credit hours)

Less than part-time (Less than 6 hours)

How many hours are you taking?(Required)

Will you live:(Required)

On Campus

Off Campus

With Parents

Other

Have you applied other scholarships?(Required)

Yes

If no, please explain why not:

Have you received other scholarships?(Required)

Yes

APPLICANT STATEMENT: I also certify that the information provided in my application is, to the best of my knowledge, complete and accurate. I understand that false statements on this application will disqualify me from a scholarship. I further certify that, if funds are received, they will be used for the educational purposes for which they are granted. I also give permission for my high school to release any information necessary to process my application.

Applicant’s Signature(Required)

Digital Signature

Date(Required)

MM slash DD slash YYYY

Parent Signature(Required)

Digital Signature

Date(Required)

MM slash DD slash YYYY

FINANCIAL AID ASSISTANCE QUESTIONNAIRE

Student Name(Required)

Social Security (Last 4 digits)(Required)

INCOME, EXPENSES, AND ASSET DATA This information is required to assess the financial need of each applicant. Please complete the STUDENT INFORMATION section of this form. If you are a dependent student, you must also have your parents complete the PARENT INFORMATION section. If federal income taxes for the 2010 year have not been filed by the time you are filling this out, you must use estimated numbers. If you are an independent student, information about you and your spouse, if applicable, must be included. It will be treated as CONFIDENTIAL information and used ONLY for the purpose of applicant evaluation by the scholarship committees. You must attach copies of one of the following: (1) the most recent federal income tax return filed by your parents as well as your own, if you were required to file. (DO NOT INCLUDE W-2 OR SCHEDULES) or (2) your Student Aid Report (SAR). Applications without these documents will not be considered
STUDENT INFORMATION
Source of financial information(Required)

Actual numbers/Already filed

Estimated number to be filed
Check one
Annual adjusted gross income

Total annual income earned/received from all sources
Student $(Required)

Occupation(Required)

Employer(Required)

Student (Other income $)

(alimony, child support, government benefits, etc.)
Student Marital Status(Required)

Single

Married

Divorced

Widowed

Seperated
Students Spouse Income $

Occupation

Employer

Students Spouse (Other income $)

(alimony, child support, government benefits, etc.)

PARENT INFORMATION

Source of financial information(Required)

Actual numbers/Already filed

Estimated number to be filed

Check one

Annual adjusted gross income

Total annual income earned/received from all sources

Father/Stepfather $(Required)

Occupation(Required)

Employer(Required)

Father/Stepfather (Other income $)

(alimony, child support, government benefits, etc.)

Mother/Stepmother $(Required)

Occupation(Required)

Employer(Required)

Mother/Stepmother (Other income $)

(alimony, child support, government benefits, etc.)

Marital Status(Required)

Single

Married

Divorced

Widowed

Seperated

Total number of people living in the household

Including those who are not dependents

List all dependents other than the applicant:

Name

Age

Relationship to Applicant

School, College or Occupation

Name

Age

Relationship to Applicant

School, College or Occupation

Name

Age

Relationship to Applicant

School, College or Occupation

Will you be receiving any of the following financial resources to assist you with your college expenses?

Financial Aid from your college/university

Yes

Pending

Total Amount(s)

Grants

Yes

Pending

Total Amount(s)

Scholarships *

Yes

Pending

Total Amount(s)

Loans

Yes

Pending

Total Amount(s)

Work Study

Yes

Pending

Total Amount(s)

Tuition waiver

Yes

Pending

Total Amount(s)

Veteran’s educational benefits

Yes

Pending

Total Amount(s)

Tuition reimbursement from employer

Yes

Pending

Total Amount(s)

Family contribution

Yes

Pending

Total Amount(s)

Savings

Yes

Pending

Total Amount(s)

Other

Yes

Pending

Total Amount(s)

*Please list all scholarships for which you have applied. If the scholarship has been awarded to you, include the amount beside the name of the scholarship.

Name of Scholarship

Total Amount(s)

Name of Scholarship

Total Amount(s)

Name of Scholarship

Total Amount(s)

Part of the criteria is financial need. Describe personal or family circumstances that make it necessary for you to seek aid for your education. If you and your family have unusual circumstances, such as illnesses not covered by insurance, unemployment, etc. that affect income, please include those as well.(Required)

CERTIFICATION I/We certify that the information in this application is true and complete to the best of my knowledge. I/We will supply any additional information The Community Foundation may request.

Applicant Signature(Required)

Digital Signature

Date(Required)

MM slash DD slash YYYY

Parent (Spouse) Signature(Required)

Digital Signature

Date(Required)

MM slash DD slash YYYY

Untitled

First Choice

Second Choice

Third Choice

Phone

This field is for validation purposes and should be left unchanged.