Southeastern Community College


TRiO Scholarship Application

 

* denotes optional information.

Personal Information

First Name:

Middle Name: If no legal middle name, please enter 'x'

Last Name:

* Maiden Name:

* Other Last Name:

Social Security Number:

Birth Date: in MMDDYYYY format

* E-mail Address:

Address

* P.O. Box:

* Full Street Address:

City:

State:

Zip Code:

Phone Numbers

Home Phone: Please include your area code.

* Cell Phone: Please include your area code.

* Work Phone: Please include your area code.

Program Pursuing at SCC:

 

Describe how you have utilized TRiO Services:

Why do you feel that you are deserving of the TRiO scholarship:

 

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