Other Names That May Appear On Academic Records

Date of Birth* (MM/DD/YYYY)

Parents, spouse, legal guardians, or others who know where you can be reached.

Please note the requirements of each scholarship, which are provided in the Scholarship Descriptions.

When completing your application, be sure that you submit the required materials for each scholarship for which you are applying. Because the scholarship process is competitive, merely applying does not guarantee that you will receive a scholarship. In addition, it is improbable that a student will be awarded more than one scholarship. For that reason, it is important that you apply for scholarships that you meet the requirements for and feel your qualifications would make you a strong candidate.

To apply for a Foundation scholarship you must have a minimum cumulative GPA of 2.0, be a high school graduate or have a GED, AND be enrolled in a minimum of six (6) credits.

Requirements of full-time enrollment (12 credits per semester) may be waived for students enrolled in a Health Technology program, if the required courses are being taken each semester. Full-time enrollment for Health Technology is 10 credits per semester.

List the scholarships for which you are applying in order of preference-you may apply for a maximum of five (5) scholarships.

* You must select at least one below

1. Select ValueAccess Annual Scholarship Al Pollard Memorial Scholarships for the Culinary Arts - Benefiting First Year Students Al Pollard Memorial Scholarships for the Culinary Arts - Benefiting Second Year Students Alice Becker Hinchcliffe Williams Endowed Scholarship Alumni Association Annual Book Scholarship American Sign Language Endowed Scholarship in Memory of Laura Knight Schowe Bank of Botetourt Art by the James Series Annual Scholarship Barry L. Pendrey Memorial Scholarship Belmont Presbyterian Church Annual Scholarship Beverly Day Williamson, Jr. Endowed Scholarship Bridging the Gap Endowed Scholarship Brown & Sons Farm Annual Scholarship Commonwealth Council Women's Leadership Scholarship Continental Societies Endowed Scholarship David L. Nickerson Honorary Endowed Scholarship Dennis R. Cronk Endowed Scholarship Dr. & Mrs. Abe Jacobson Annual Scholarship Dr. George K. Bowers Youth Haven-Sanctuary Endowed Scholarship Edward G. Magruder Honorary Annual Scholarship Elizabeth Wright Painter Memorial Annual Scholarship Employee Annual Giving Scholarship Employee Family Scholarship Fred Whitaker Company Annual Scholarship Friendship Annual Scholarship Gerry Montgomery Meador Endowed Scholarship Gertrude Light Hubbard Annual Scholarship Hall Associates Annual Scholarship HoneyTree Early Learning Center Endowed Scholarship Hugh E. Davis Annual Nursing Scholarship James Mark Mitchell Memorial Art Endowed Scholarship John B. Williamson, III Honorary Endowed Scholarship Katherine Futrell Honorary Endowed Scholarship Lewis-Gale Medical Center Endowed Scholarship Lucian Y. and June B. Grove Honorary Endowed Scholarship Maurice Strausbaugh Memorial Annual Scholarship McFarland Endowed Scholarship Mike Bassett Memorial Endowed Scholarship Mr. & Mrs. Emanuel Payne Endowed Scholarship New City Media Annual Scholarship for Communication Design Nicholas E. Janney Memorial Scholarship Nursing Endowed Scholarship—Academic Achievement Nursing Endowed Scholarship—Financial Need Odasz Annual Scholarship Orrin Clifton Annual Scholarship Prestige Motorcycle Club Annual Scholarship Raymond and Melvin Hubbard Annual Scholarship Rita Halsey David Radiography Endowed Scholarship Roanoke Electric Steel Corporation Endowed Scholarship Sister Eveline Murray Annual Scholarship Stanard and Betty Lanford Endowed Scholarship Stanard F. Lanford Commonwealth Legacy Scholarship The John Mathis, MD and Krista Crawford-Mathis Endowed Scholarship The Roanoke Tribune Annual Scholarship Walter Darnall Vinyard Endowed Scholarship William Frank Burton, Jr. Annual Scholarship William Milton Meador Endowed Scholarship
   


2. Select ValueAccess Annual Scholarship Al Pollard Memorial Scholarships for the Culinary Arts - Benefiting First Year Students Al Pollard Memorial Scholarships for the Culinary Arts - Benefiting Second Year Students Alice Becker Hinchcliffe Williams Endowed Scholarship Alumni Association Annual Book Scholarship American Sign Language Endowed Scholarship in Memory of Laura Knight Schowe Bank of Botetourt Art by the James Series Annual Scholarship Barry L. Pendrey Memorial Scholarship Belmont Presbyterian Church Annual Scholarship Beverly Day Williamson, Jr. Endowed Scholarship Bridging the Gap Endowed Scholarship Brown & Sons Farm Annual Scholarship Commonwealth Council Women's Leadership Scholarship Continental Societies Endowed Scholarship David L. Nickerson Honorary Endowed Scholarship Dennis R. Cronk Endowed Scholarship Dr. & Mrs. Abe Jacobson Annual Scholarship Dr. George K. Bowers Youth Haven-Sanctuary Endowed Scholarship Edward G. Magruder Honorary Annual Scholarship Elizabeth Wright Painter Memorial Annual Scholarship Employee Annual Giving Scholarship Employee Family Scholarship Fred Whitaker Company Annual Scholarship Friendship Annual Scholarship Gerry Montgomery Meador Endowed Scholarship Gertrude Light Hubbard Annual Scholarship Hall Associates Annual Scholarship HoneyTree Early Learning Center Endowed Scholarship Hugh E. Davis Annual Nursing Scholarship James Mark Mitchell Memorial Art Endowed Scholarship John B. Williamson, III Honorary Endowed Scholarship Katherine Futrell Honorary Endowed Scholarship Lewis-Gale Medical Center Endowed Scholarship Lucian Y. and June B. Grove Honorary Endowed Scholarship Maurice Strausbaugh Memorial Annual Scholarship McFarland Endowed Scholarship Mike Bassett Memorial Endowed Scholarship Mr. & Mrs. Emanuel Payne Endowed Scholarship New City Media Annual Scholarship for Communication Design Nicholas E. Janney Memorial Scholarship Nursing Endowed Scholarship—Academic Achievement Nursing Endowed Scholarship—Financial Need Odasz Annual Scholarship Orrin Clifton Annual Scholarship Prestige Motorcycle Club Annual Scholarship Raymond and Melvin Hubbard Annual Scholarship Rita Halsey David Radiography Endowed Scholarship Roanoke Electric Steel Corporation Endowed Scholarship Sister Eveline Murray Annual Scholarship Stanard and Betty Lanford Endowed Scholarship Stanard F. Lanford Commonwealth Legacy Scholarship The John Mathis, MD and Krista Crawford-Mathis Endowed Scholarship The Roanoke Tribune Annual Scholarship Walter Darnall Vinyard Endowed Scholarship William Frank Burton, Jr. Annual Scholarship William Milton Meador Endowed Scholarship
   


3. Select ValueAccess Annual Scholarship Al Pollard Memorial Scholarships for the Culinary Arts - Benefiting First Year Students Al Pollard Memorial Scholarships for the Culinary Arts - Benefiting Second Year Students Alice Becker Hinchcliffe Williams Endowed Scholarship Alumni Association Annual Book Scholarship American Sign Language Endowed Scholarship in Memory of Laura Knight Schowe Bank of Botetourt Art by the James Series Annual Scholarship Barry L. Pendrey Memorial Scholarship Belmont Presbyterian Church Annual Scholarship Beverly Day Williamson, Jr. Endowed Scholarship Bridging the Gap Endowed Scholarship Brown & Sons Farm Annual Scholarship Commonwealth Council Women's Leadership Scholarship Continental Societies Endowed Scholarship David L. Nickerson Honorary Endowed Scholarship Dennis R. Cronk Endowed Scholarship Dr. & Mrs. Abe Jacobson Annual Scholarship Dr. George K. Bowers Youth Haven-Sanctuary Endowed Scholarship Edward G. Magruder Honorary Annual Scholarship Elizabeth Wright Painter Memorial Annual Scholarship Employee Annual Giving Scholarship Employee Family Scholarship Fred Whitaker Company Annual Scholarship Friendship Annual Scholarship Gerry Montgomery Meador Endowed Scholarship Gertrude Light Hubbard Annual Scholarship Hall Associates Annual Scholarship HoneyTree Early Learning Center Endowed Scholarship Hugh E. Davis Annual Nursing Scholarship James Mark Mitchell Memorial Art Endowed Scholarship John B. Williamson, III Honorary Endowed Scholarship Katherine Futrell Honorary Endowed Scholarship Lewis-Gale Medical Center Endowed Scholarship Lucian Y. and June B. Grove Honorary Endowed Scholarship Maurice Strausbaugh Memorial Annual Scholarship McFarland Endowed Scholarship Mike Bassett Memorial Endowed Scholarship Mr. & Mrs. Emanuel Payne Endowed Scholarship New City Media Annual Scholarship for Communication Design Nicholas E. Janney Memorial Scholarship Nursing Endowed Scholarship—Academic Achievement Nursing Endowed Scholarship—Financial Need Odasz Annual Scholarship Orrin Clifton Annual Scholarship Prestige Motorcycle Club Annual Scholarship Raymond and Melvin Hubbard Annual Scholarship Rita Halsey David Radiography Endowed Scholarship Roanoke Electric Steel Corporation Endowed Scholarship Sister Eveline Murray Annual Scholarship Stanard and Betty Lanford Endowed Scholarship Stanard F. Lanford Commonwealth Legacy Scholarship The John Mathis, MD and Krista Crawford-Mathis Endowed Scholarship The Roanoke Tribune Annual Scholarship Walter Darnall Vinyard Endowed Scholarship William Frank Burton, Jr. Annual Scholarship William Milton Meador Endowed Scholarship
   


4. Select ValueAccess Annual Scholarship Al Pollard Memorial Scholarships for the Culinary Arts - Benefiting First Year Students Al Pollard Memorial Scholarships for the Culinary Arts - Benefiting Second Year Students Alice Becker Hinchcliffe Williams Endowed Scholarship Alumni Association Annual Book Scholarship American Sign Language Endowed Scholarship in Memory of Laura Knight Schowe Bank of Botetourt Art by the James Series Annual Scholarship Barry L. Pendrey Memorial Scholarship Belmont Presbyterian Church Annual Scholarship Beverly Day Williamson, Jr. Endowed Scholarship Bridging the Gap Endowed Scholarship Brown & Sons Farm Annual Scholarship Commonwealth Council Women's Leadership Scholarship Continental Societies Endowed Scholarship David L. Nickerson Honorary Endowed Scholarship Dennis R. Cronk Endowed Scholarship Dr. & Mrs. Abe Jacobson Annual Scholarship Dr. George K. Bowers Youth Haven-Sanctuary Endowed Scholarship Edward G. Magruder Honorary Annual Scholarship Elizabeth Wright Painter Memorial Annual Scholarship Employee Annual Giving Scholarship Employee Family Scholarship Fred Whitaker Company Annual Scholarship Friendship Annual Scholarship Gerry Montgomery Meador Endowed Scholarship Gertrude Light Hubbard Annual Scholarship Hall Associates Annual Scholarship HoneyTree Early Learning Center Endowed Scholarship Hugh E. Davis Annual Nursing Scholarship James Mark Mitchell Memorial Art Endowed Scholarship John B. Williamson, III Honorary Endowed Scholarship Katherine Futrell Honorary Endowed Scholarship Lewis-Gale Medical Center Endowed Scholarship Lucian Y. and June B. Grove Honorary Endowed Scholarship Maurice Strausbaugh Memorial Annual Scholarship McFarland Endowed Scholarship Mike Bassett Memorial Endowed Scholarship Mr. & Mrs. Emanuel Payne Endowed Scholarship New City Media Annual Scholarship for Communication Design Nicholas E. Janney Memorial Scholarship Nursing Endowed Scholarship—Academic Achievement Nursing Endowed Scholarship—Financial Need Odasz Annual Scholarship Orrin Clifton Annual Scholarship Prestige Motorcycle Club Annual Scholarship Raymond and Melvin Hubbard Annual Scholarship Rita Halsey David Radiography Endowed Scholarship Roanoke Electric Steel Corporation Endowed Scholarship Sister Eveline Murray Annual Scholarship Stanard and Betty Lanford Endowed Scholarship Stanard F. Lanford Commonwealth Legacy Scholarship The John Mathis, MD and Krista Crawford-Mathis Endowed Scholarship The Roanoke Tribune Annual Scholarship Walter Darnall Vinyard Endowed Scholarship William Frank Burton, Jr. Annual Scholarship William Milton Meador Endowed Scholarship
   


5. Select ValueAccess Annual Scholarship Al Pollard Memorial Scholarships for the Culinary Arts - Benefiting First Year Students Al Pollard Memorial Scholarships for the Culinary Arts - Benefiting Second Year Students Alice Becker Hinchcliffe Williams Endowed Scholarship Alumni Association Annual Book Scholarship American Sign Language Endowed Scholarship in Memory of Laura Knight Schowe Bank of Botetourt Art by the James Series Annual Scholarship Barry L. Pendrey Memorial Scholarship Belmont Presbyterian Church Annual Scholarship Beverly Day Williamson, Jr. Endowed Scholarship Bridging the Gap Endowed Scholarship Brown & Sons Farm Annual Scholarship Commonwealth Council Women's Leadership Scholarship Continental Societies Endowed Scholarship David L. Nickerson Honorary Endowed Scholarship Dennis R. Cronk Endowed Scholarship Dr. & Mrs. Abe Jacobson Annual Scholarship Dr. George K. Bowers Youth Haven-Sanctuary Endowed Scholarship Edward G. Magruder Honorary Annual Scholarship Elizabeth Wright Painter Memorial Annual Scholarship Employee Annual Giving Scholarship Employee Family Scholarship Fred Whitaker Company Annual Scholarship Friendship Annual Scholarship Gerry Montgomery Meador Endowed Scholarship Gertrude Light Hubbard Annual Scholarship Hall Associates Annual Scholarship HoneyTree Early Learning Center Endowed Scholarship Hugh E. Davis Annual Nursing Scholarship James Mark Mitchell Memorial Art Endowed Scholarship John B. Williamson, III Honorary Endowed Scholarship Katherine Futrell Honorary Endowed Scholarship Lewis-Gale Medical Center Endowed Scholarship Lucian Y. and June B. Grove Honorary Endowed Scholarship Maurice Strausbaugh Memorial Annual Scholarship McFarland Endowed Scholarship Mike Bassett Memorial Endowed Scholarship Mr. & Mrs. Emanuel Payne Endowed Scholarship New City Media Annual Scholarship for Communication Design Nicholas E. Janney Memorial Scholarship Nursing Endowed Scholarship—Academic Achievement Nursing Endowed Scholarship—Financial Need Odasz Annual Scholarship Orrin Clifton Annual Scholarship Prestige Motorcycle Club Annual Scholarship Raymond and Melvin Hubbard Annual Scholarship Rita Halsey David Radiography Endowed Scholarship Roanoke Electric Steel Corporation Endowed Scholarship Sister Eveline Murray Annual Scholarship Stanard and Betty Lanford Endowed Scholarship Stanard F. Lanford Commonwealth Legacy Scholarship The John Mathis, MD and Krista Crawford-Mathis Endowed Scholarship The Roanoke Tribune Annual Scholarship Walter Darnall Vinyard Endowed Scholarship William Frank Burton, Jr. Annual Scholarship William Milton Meador Endowed Scholarship

Criteria for several scholarships require you to detail certain information. Please carefully read the requirements for the scholarships for which you are applying. If a scholarship requires detailed information, such as your commitment to a career, your employer, employer of a family member, living in the area, etc., use the following space to address the requirement.

Please print the Statements of Recommendation. YOU MUST PRINT THESE FORMS AND PROVIDE THEM TO TWO INDIVIDUALS WHO WILL RECOMMEND YOU. One recommendation statement should be completed by a Virginia Western instructor and one recommendation statement should be completed by an individual outside of Virginia Western. Be sure to ask the Virginia Western instructor to write your recommendation before classes end on April 26! If you have never attended Virginia Western, you may request the statements be completed by two individuals outside of Virginia Western. Please do not use statements from relatives. Former teachers, employers and colleagues at work are good resources for recommendations.The person who completes the recommendation should return the form to the Foundation office by 4:00 p.m., May 23, 2008.

Who are the two individuals you asked to complete recommendations?

* = Required Field

If you are currently in high school or have graduated from high school (includes dual enrollment) please provide a high school transcript. If you have completed a GED, received a high school diploma through an alternative program, or have completed at least three GED tests, please submit proof of this completion along with your scholarship application. If you have completed at least one semester of college work at Virginia Western or transferred to Virginia Western from another institution, please provide your college transcripts (VWCC transcripts may be printed from http://vw.my.vccs.edu). Upon entering VWCC, you must have a high school diploma or GED.

All transcripts or proof of GED completion must be in the Foundation office no later than 4:00 p.m., May 23, 2008. Materials may be mailed to VWCC Educational Foundation, P.O. Box 14007, Roanoke, VA 24038-4007, or hand delivered to the Foundation office located in Fishburn Hall #214. Please do not send transcripts to the admissions department.

* = Required

Are you currently enrolled at Virginia Western?* NoYes

• If yes (note, you must complete if you answered "Yes" above):
  How many credits have you earned
  Program currently enrolled Select Value Accounting Medical Office Specialist Medical Transcriptionist Welding Veterinary Technology Administrative Support Technology Surgical Technology - Distance Learning Program Administration of Justice Air Conditioning & Refrigeration Building Construction Trades Business Administration Business Industrial Supervision CISCO CCNA Networking Clerical Studies Communication Design Computer & Electronics Technology Dental Hygiene Early Childhood Development Electrical Wiring Engineering Firefighting & Prevention General Studies Fire Science Specialization Health Records Coding Health Technology Core for AAS Degree Programs (Dental Hygiene, Nursing, and Radiography) Interior Landscaping/Floriculture Specialization Horticulture - Floral Design & Indoor Plant Care Horticulture - Landscaping & Outdoor Plant Care Horticulture - Plant Propagation & Production Horticulture - Urban Tree Management Electromechanical Technology Welding: Welding and Metal Processing Information Systems Technology Interior Design Paralegal Studies Liberal Arts Management Mechanical Engineering Technology (Automated Manufacturing Emphasis) Microcomputer Systems Technology Nursing Office Assistant Office Technology Pharmacy Technician Practical Nursing Radiography Radiation Oncology Science Social Sciences Emergency Medical Technician - Basic Technician Geographical Information Systems Geographical Information Systems Career Exploration Horticulture Technology - Interior Landscaping/Floriculture Specialization Horticulture Technology - Landscape Specialization Human Services Medical Office Records Management Nursing - Commonwealth Nursing Technical Studies: Electromechanical Technology Specialization IT: Web Scripting and Design Wellness Automotove Analysis and Repair College Preparation in English Welding: Intensive Welding Training College Preparation in Mathematics Computer Aided Drafting Career Exploration Culinary Arts Technical Studies Maintenance Technology Architectural/Civil Engineering Technology
  Who is your VWCC academic advisor?
• If no (note, you must complete if you answered "No" above):
  When will you enroll (semester and year) Select Value Spring 2008 Summer 2008 Fall 2008 Spring 2009 Summer 2009 Fall 2009 Spring 2010 Summer 2010 Fall 2010 Spring 2011 Summer 2011 Fall 2011 Spring 2012 Summer 2012 Fall 2012
  Program of study Select Value Accounting Medical Office Specialist Medical Transcriptionist Welding Veterinary Technology Administrative Support Technology Surgical Technology - Distance Learning Program Administration of Justice Air Conditioning & Refrigeration Building Construction Trades Business Administration Business Industrial Supervision CISCO CCNA Networking Clerical Studies Communication Design Computer & Electronics Technology Dental Hygiene Early Childhood Development Electrical Wiring Engineering Firefighting & Prevention General Studies Fire Science Specialization Health Records Coding Health Technology Core for AAS Degree Programs (Dental Hygiene, Nursing, and Radiography) Interior Landscaping/Floriculture Specialization Horticulture - Floral Design & Indoor Plant Care Horticulture - Landscaping & Outdoor Plant Care Horticulture - Plant Propagation & Production Horticulture - Urban Tree Management Electromechanical Technology Welding: Welding and Metal Processing Information Systems Technology Interior Design Paralegal Studies Liberal Arts Management Mechanical Engineering Technology (Automated Manufacturing Emphasis) Microcomputer Systems Technology Nursing Office Assistant Office Technology Pharmacy Technician Practical Nursing Radiography Radiation Oncology Science Social Sciences Emergency Medical Technician - Basic Technician Geographical Information Systems Geographical Information Systems Career Exploration Horticulture Technology - Interior Landscaping/Floriculture Specialization Horticulture Technology - Landscape Specialization Human Services Medical Office Records Management Nursing - Commonwealth Nursing Technical Studies: Electromechanical Technology Specialization IT: Web Scripting and Design Wellness Automotove Analysis and Repair College Preparation in English Welding: Intensive Welding Training College Preparation in Mathematics Computer Aided Drafting Career Exploration Culinary Arts Technical Studies Maintenance Technology Architectural/Civil Engineering Technology

Do you or will you have a high school diploma?* NoYes

• If yes
  (note, you must complete if you answered "Yes" above):
  
  

  Month / Year received or anticipated	(MM/YYYY)
  Name of High School
  City
  State	Select Value Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont NW Territories Virginia Washington West Virginia Wisconsin Wyoming Puerto Rico Alberta British Columbia Manitoba NEWFOUNDLAND New Brunswick Nova Scotia Ontario Prince Edward Island Saskatchewan Yukon Quebec
  High School cumulative grade point average (GPA)

Do you have a GED?* NoYes

If yes
(note, you must complete if you answered "Yes" above):

• Year received or will receive
• Average Score

What is the highest degree you have been awarded?
(AA/AS; BA/BS; MA/MS; doctorate)

COMPLETE ONLY ONE SECTION - Section A OR Section B - not both
* = Required

• A. Self-Supporting Students:
  
  

  Marital Status:

  Single Seperated Divorced Married

  
  

  # of dependent children
  # of members in household: (including yourself)
  # of members of household in college: (including yourself)

  
  Total household annual income: 
  Below $25,000
  $25,000 - $34,999
  $35,000 - $44,999
  $45,000 - $54,999
  $55,000 - $64,999
  $65,000 - $74,999
  Above $75,000
  
  
  You must send a copy of your signed tax return (do not send copies of schedules) no later than 4:00 p.m., May 23, 2008 to the VWCC Educational Foundation, P.O. Box 14007, Roanoke, VA 24038-4007, or hand deliver to the Foundation office located in Fishburn Hall #F214.

• B. Dependent Students:
  

  Parents' Name(s):
  Address:
  # of members in household: (including yourself)
  # of members in household in college: (including yourself)

  
  Parents' combined household annual income:
  Below $25,000
  $25,000 - $34,999
  $35,000 - $44,999
  $45,000 - $54,999
  $55,000 - $64,999
  $65,000 - $74,999
  Above $75,000
   
  You must send a copy of your parents' signed tax return (do not send copies of schedules) no later than 4:00 p.m., May 23, 2008 to the VWCC Educational Foundation, P.O. Box 14007, Roanoke, VA 24038-4007, or hand deliver to the Foundation office located in Fishburn Hall #F214.

If yes, explain:

IN THE SPACE BELOW, PROVIDE A 250-WORD ESSAY . Evaluation of your essay is based on organization, grammar, spelling, and how well you address the topic. Please address ONE of the following in your essay - Note the question you address at the top of your essay:

1. What is a societal problem you believe needs to be addressed? Explain why and how.
2. Discuss a special attribute or accomplishment that sets you apart.
3. Who in your life has been your biggest influence and why?
4. Where do you see yourself 10 years from now?
5. Choose a book or books that have affected you deeply and explain why.

Note: The essay is required

Some scholarship funds come from private sources, which are designated for specific students. To be considered for these special scholarships, additional documentation may be required.

Sex: FemaleMale

Are you a U.S. Citizen? NoYes

Ethnic Identity

• African-American
  Native American/Alaskan Native
  Asian/Pacific Islander
  Caucasian (not Hispanic)
  Hispanic
  Bi/Multi racial (please specify)
  Other (please specify)
  
  

Have either of your parents (or guardians) graduated from college?
NoYes

I certify that, to the best of my knowledge, the information provided on this application is complete and accurate. I have read and understand the scholarship guidelines and the criteria for eligibility to receive the scholarship. I authorize Virginia Western Community College to furnish copies of this application, essay and other attachments to, as well as exchange financial aid eligibility information with, any of the scholarship committee members and/or donors. I hereby give approval for Virginia Western Community College to issue a news release if I am awarded a scholarship, listing my name, hometown, and the name and amount of the scholarship. Furthermore, unless a written statement to the contrary is filed with the Foundation Office, all scholarship recipients give authorization to Virginia Western Community College to publish photographs of themselves for promotional purposes.

Note: Your response is required

I Agree YesNo

Use this section to ensure that you have completed your application properly and included the correct information.

• Print a copy of your application to keep as a backup should the Foundation not receive your completed online application. You can do this from the page you see after you press SUBMIT.
  
  
• Submit your online application
  
  
• Provide the following to the Foundation office by 4:00 p.m., May 23, 2008
  • VWCC or high school transcript(s), or proof of GED
  • Materials required for specific scholarships
  • Copy of your signed tax return, or your parents' signed tax return (do not include copies of schedules)
    
    
• Provide recommendation forms to two individuals which must be returned by these individuals to the Foundation office by 4:00 p.m., May 23, 2008
  

Please assist us with future promotion of the Foundation scholarships. How did you hear about the Virginia Western Educational Foundation Scholarships (website, posters, postcards, radio, cable, etc.)?

Hand Deliver To:
VWCC Educational Foundation, Inc.
Fishburn Hall, Suite 214

Mail to:
VWCC Educational Foundation, Inc.
P. O. Box 14007
Roanoke, VA 24038 - 4007

Virginia Western is an equal opportunity/affirmative action institution.
TTY: 1.800.855.2880  All Users:  711

PLEASE REVIEW YOUR APPLICATION CAREFULLY BEFORE SUBMITTING.