Okefenokee Technical College Foundation Scholarship Application for Coastal Pines Technical College Students
List in chronlogical oder the post-secondary schools/colleges that you attended beyond high school. Give degrees/diplomas eared.
Current Quarter Class Schedule:
What do you plan to do after graduating from CPTC? What are your long-term career goals?
Please list amounts (in dollar amount) of any of the following you currently receive or will receive:
Please explain any other income you receive to attend college (parents, etc.).
Please answer the following questions in order for the scholarship committee to determine if you qualify for specific scholarships:
I certify this information to be true to the best of my knowledge, and I hereby give permission for disclosure of records to the Okefenokee Technical College Foundation internal staff members, selection committee members, trustees and other staff.
PLEASE RESPOND TO THE FOLLOWING STATEMENTS.
Type your response and attach it to this application or e-mail it to Mrs. Johnson. We sometimes share responses with our donors. Please take your time and do a good job.
Describe yourself and your background.
Why did you select Coastal Pines Technical College to continue your education?
Explain your reasons for seeking a scholarship and how you would use the money. Be specific, and include details about your circumstances that may assist the scholarship committee in making their decision.
Provide additional information that will assist the Scholarship committee in making a decision.
THE FOLLOWING STATEMENTS MUST BE SIGNED BY THE APPLICANT.
In the event that I am awarded the scholarship, I agree to attend Coastal Pines Technical College. I declare that the information reported is true, correct, and complete. I accept the terms of the above agreement and agree for my name to be listed as a scholarship recipient. I also agree to allow the scholarship committee to review my transcript for decision purposes.
I authorize the release of my transcript to the scholarship committee to review for the purpose of evaluating this scholarship application.
NEWS RELEASE STATEMENT
I, the undersigned, do hereby give permission to Coastal Pines Technical College and the Okefenokee Technical College Foundation to use my name and/or photograph picturing or naming me as a recipient of this or any other scholarship and/or in a school/work related situation.
EQUAL OPPORTUNITY STATEMENT
As set forth in the student catalog, Coastal Pines Technical College (CPTC) does not discriminate on the basis of race, color, creed, national or ethnic origin, gender, religion, disability, age, political affiliation or belief, genetic information, veteran status, or citizenship status (except in those special circumstances permitted or mandated by law). The following persons have been designated to coordinate the College’s implementation of non-discrimination policies: Katrina Howard, Title IX Coordinator, Jesup Campus, Office 132, email@example.com, 912.427.5876; Cynthia Linder, Title IX Coordinator, Waycross Campus, firstname.lastname@example.org, 912.287.4098; Cathy Montgomery, ADA/Section 504 Coordinator, Jesup Campus, Office 174, email@example.com, 912.427.6265; and Karen Boyle, ADA/Section 504 Coordinator, Waycross Campus, Office 122, firstname.lastname@example.org, 912.285.6119.
Written applications can be submitted to Shaylyn Johnson in Room 1415.
Shaylyn Johnson, Project Assistant
Okefenokee Technical College Foundation
1701 Carswell Avenue
Waycross, GA 31503
(912) 287- 6598
FAX (912) 338-5300
CPTC is an Equal Opportunity Institution.