Application – BCM SCHOLARS

(A) PERSONAL INFORMATION

Date of Application*

Name

First Last

Date of Birth*

Address*

Street Address City State / Province / Region ZIP / Postal Code

Home Phone

Cell Phone*

Email*

(B) Educational Information

Name of High School*

Address*

Street Address City State / Province / Region ZIP / Postal Code

Grade Point Average*

SAT Score*

ACT Score*

Most recent High School Transcript

Please select your most recent high school transcript by clicking the "select files" button or drag & drop your document HERE.

Drop files here or

Max. file size: 128 MB, Max. files: 4.

(C) College Application Information

Please Submit Acceptance Letter With Application

Name of College*

Address*

Street Address City State / Province / Region ZIP / Postal Code

Phone (Registrar's Office)*

(D) FAMILY INFORMATION

Name of Parent(s) or Guardian*

Occupation*

Relationship to Applicant (Parent or Guardian)*

Home Phone

Work Phone

Cell Phone*

Would you like to add an additional parent?*

Name of Parent(s) or Guardian*

Occupation*

Relationship to Applicant (Parent or Guardian)*

Home Phone

Work Phone

Cell Phone*

Submit a copy of the acceptance letter from the college and a letter from the college registrar confirming enrollment and listing first semester classes.
Parent's Income: Page one of most recent IRS Tax Form (if you are a dependent).
Your Free Application for Federal Student Aid form. (The FAFSA is available from high school guidance offices, college financial aid offices, via the web at www.fafsa.ed.gov or by calling 1-800-433-3243).
Two Letters of Reference (one from former teacher and another of your choosing).
A 500-word essay describing an accomplishment or event. Discuss an accomplishment or event that marked your transition from childhood to adulthood within your culture, community, or family.
List of extracurricular activities (church, sports, clubs, organizations, volunteer, etc).
List of employment history.

Document Needed File Add

Please select your files by clicking the "select files" button or drag & drop all documents needed.

Drop files here or

Max. file size: 128 MB.

Statement of Accuracy

I hereby affirm that all the above stated information provided by me is true and correct to the best of my knowledge. I also consent that my picture or video may be taken and used for any purpose deemed necessary to promote the B. Courtney McBath Scholarship Fund.

I hereby understand that if chosen as a scholarship winner, I must provide evidence of enrollment/registration at the post-secondary institution of my choice before scholarship funds can be awarded.

Applicant Initial*

Signature of Scholarship Applicant*

Date*

BCM Scholar Online Application

(A) PERSONAL INFORMATION

(B) Educational Information

(C) College Application Information

(D) FAMILY INFORMATION

Statement of Accuracy