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Congratulations on your academic achievement. Although your academic record is of primary importance, please take the time to fill out this application, which will allow the scholarship committee to know what other qualifications distinguish you as a candidate for a merit scholarship. Please complete and mail or deliver in person by FRIDAY, APRIL 13, 2012, the completed application to the Educational Foundation Office. LATE APPLICATIONS WILL NOT BE CONSIDERED! For more information, contact the Foundation Office at 540/863-2837 or 863-2835.
You must ensure that your application along with your official transcript, two letters of recommendation — one of which must be from your high school math or English teacher — (letters from family members are unacceptable), essays and a signed information release form are received by the foundation office no later than FRIDAY, APRIL 13, 2012. Your application may be printed and delivered in person or mailed to the address below. Please note: If you wish to be considered for the Commonwealth Legacy Scholarship an additional essay detailing your leadership and mentoring potential is REQUIRED. An interview also may be required. Please attach the CLS Information sheet to your application.
In addition to the above materials, you must have applied for admission to Dabney S. Lancaster Community College |
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Dabney S. Lancaster Community College
Educational Foundation, Inc.
P.O. BOX 1000
Clifton Forge, Virginia 24422-1000
540-863-2837 OR 540-863-2835
(TOLL-FREE: 877-73DSLCC)
FAX: 540-863-2915
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Name:
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Address:
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City:
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State:
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Zip:
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High school:
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Home phone number:
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Email address:
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SSN:
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Curriculum desired at DSLCC:
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1. Explain your career goals--where do you see yourself in five years?
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| In order to publicize the Foundation's scholarship programs and promote DSLCC, this award (along with your name as recipient) will be announced in local news outlets and the DLSCC website. |
3. List any extracurricular activites in which you are involved. Please include years of involvement, offices held or honors bestowed
You may indicate years of involvement as "Freshman, Junior, Senior", etc.
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4. List community involvement and/or jobs you have held, including volunteer work. Please include years of participation, offices held and honors bestowed.
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If your father is/was a DSLCC alumnus, please provide name:
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If your mother is/was a DSLCC alumnus, please provide name:
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Parent's/guardian's names: (for news release only)
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Newspaper(s) in which you would like your news release published:
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DSLCC and the DSLCC Education Foundation, Inc., Are EEO institutions.
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