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Madison County
Chamber of Commerce

Scholarship Program Application

This application will not be considered complete without the following attachments:

  1. 1. High school or college transcript, whichever is most recent.
  2. Two (2) letters of reference from someone other than a family member; preferably one educational reference and one from someone in your community. Letters must include the contact telephone number of the individual writing the letter.
  3. Evidence of college acceptance for the coming fall.
  4. Short essay of no more than one page (single spaced) stating why you plan to return to work in Madison County upon completion of college.

Minimum Criteria for Scholarship:

  • Must have been Madison County resident for at least one year prior to seeking this scholarship. (Living in Madison County temporarily to attend college does not meet this residency requirement.)
  • Will be enrolled full-time (12 or more credit hours) for period covered by proposed scholarship
  • Must have most recent GPA of 2.5 or more.

Please print a copy of this form, complete, and submit to us by mail.
Or, Click Here to download the pdf version of the Scholarship Application.

ALL information must be complete before application will be considered. Please print legibly.


NAME:

First,                                   Middle,                                   Last,                                   Suffix                                   Name Used

MAILING ADDRESS:

Street or PO Box,                                                    City,                                                    State,                  Zip Code

Date of Birth:                                              e-mail:

Telephone: (H)                                                                              (W)

Father's Name:                                             

Father's Occupation:                                                               Highest Education Level:

Mother's Name:                                             

Mother's Occupation:                                                               Highest Education Level:

Graduation Date:                                                                      High School GPA:

High School Name and Address:


Have you taken any college classes?       No                 Yes

If yes, where:                                                                                      Cumulative College GPA:

College Enrollment Date:

Expected College Completion Date:

Program/Major:


        

Other Post-Secondary Education (if applicable):


Number of family members currenlty in college besides yourself:

Please briefly explain your educational goals:





Are you currently employed?      No                 Yes
If yes, please list your employment history

Employed by:                                               Position:                                               Dates:




Why do you deserve this scholarship?






Describe your community service, including dates:





Briefly explain your career goals:





Please list any hobbies, special interests, organizations, etc. that you may have.




Describe your community service, including dates:


Please list all other types of assistance (including federal, state, and local) scholarships or
grant funds for which you have applied or plan to apply. Please identify any which you have been awarded.



Please list any important factors that you would like to be considered when reviewing your applicaiton or worthiness for this scholarship.



Do you plan to remain in or return to Madison County upon completion of your education?
Please attach a 1 page single spaced essay in response to this question.


By my signature below, I declare that to the best of my knowledge and belief the information given here is true, correct and complete. Should I be awarded a Madison County Chamber of Commerce Scholarship, I understand that a check for standard college costs (tuition, fees, books, meal plan) will be sent to me for attendance at the college of my choice. Also, I agree to send receipts to the Chamber of Commerce documenting how I spent these funds toward my college education.

Signature:                                                                                              Date:

Witness Name:                                                                            Signature:


Applications Must Be Postmarked By: April 30
(Recipient will be recognized at the annual Scholarship Banquet in May.)

Please return to:
Chair, Scholarship Committee
Madison County Chamber of Commerce
PO Box 1085
Mars Hill, NC 28754


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Madison County Chamber of Commerce  -  PO Box 1085, Mars Hill, NC 28754
Tourism: (828) 680-9031       Toll Free: 1-877-2-Madison       Chamber: (828) 689-9351