LMCA Scholarship Foundation

This submittable application form with the following required attached files:

Official Transcript and a sealed copy of the most recent or year-end high school or college transcript, Letters of Recommendation - one to three letters from non-familial sources, such as a teacher, counselor, or supervisor.

Upload Documents (only PDF Files Accepted)

*Applicant’s First Name / Middle Name:

*Applicant’s Preferred First Name:

*Applicant’s Last Name:

*Social Security Number SSN

Date of birth

Gender

Current Student Status:

Address 1:

Address 2:

City/Town:

State:

Zip Code:

Country:

*Phone Number

Current School:

Current School Graduation Date:

Employment Information

Are you currently employed?

LMCA Affiliation Select all that apply:

Self

Spouse

Parent/Guardian

Grandparent

LMCA Member Company:

Employee Name:

Family Information:

Are you a Dependent?

Yes

Father/Grandfather/Guardian Name:

Is your father/grandfather/guardian living or deceased?

Living

Deceased

Mother/Grandmother/Guardian Name:

Is your mother/grandmother/guardian living or deceased?

Living

Deceased

Student Information

University, College or Community College:(If undecided, please list all schools applying to)

Major or Area Study:1st Choice: 2nd Choice:

Expected Student Status: (As of August 2020)

Current GPA:

GPA Scale:

ACT Score (highest composite)

SAT Score (highest composite)

Current Occupation:

Hobbies (limit 200 characters)

Extra-Curricular Activities & Awards (limit 250 characters)

Personal Situation:

Marital Status:

Single

Married

Number of Dependents: (Write N/A if not applicable)

Living Situation:

Live at home with parents

Live at home with parents, but not a dependent

Live at home – single

During your college career, will any siblings also be enrolled in college?

Yes

Annual Household Income Information:

Family Income (We rely on the integrity of your character to report this information fully and accurately. Your family’s adjusted gross income may be found on or near line 34 of the most recent U.S. Individual Federal Income Tax Form 1040. Failure to complete this section will result in the loss of any points based on financial need. All income may be subject to verification through request of annual Internal Revenue Service returns.)

Do you live in a single parent household?

Yes

Personal Narrative: (Write a personal narrative of 500 or fewer characters. Include your goals, interests, any unique circumstances or situations that impacted your life or need for scholarship and the reason(s) you are applying for a LMCA scholarship. Applications are judged anonymously. Please do not identify the LMCA member company with which you are affiliated in your essay.)

Date

Signature