Johnston County Schools Scholarship Application

Please complete this application in your own handwriting in
black ink or type and return to student services.

Applicant’s Name __________________________________________ SSN_________________________

Name of High School attending ___________________________________________________________

Home Address ___________________________ City _______________ State ______ Zip __________

Mailing Address if different ____________________________________________________________

Phone __________________________ Date of birth ______________________________

Father’s Name _______________________ Occupation ______________________________

Mother’s Name _______________________ Occupation ______________________________

Are parents divorced?______________________separated?_______________________

Name and address of legal guardian if other than parent ______________________________

______________________________________________________________________________________

How many brothers and sisters do you have? Older ___________ Younger ____________

How many brothers and sisters are currently attending college full-time?_____________

Have you submitted a Free Application for Federal Student Aid (FAFSA) this year?____

Combined parent or guardian income is under $25,000 ________ $25,000-$50,000 ______

$50,000-$75,000 ________ over $75,000 _________

Have you been offered any scholarships or financial aid?_______If yes, how much and

what is the source of this scholarship or financial aid? ______________________________

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List any unusual financial situations which you believe should be considered _________

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Class Rank______________in a class of_________________GPA__________________

SAT Scores (highest) Verbal__________Math__________Total___________________

Application Due Date____________________


Name _______________________________________________________________________________

College or University you plan to attend ___________________________________________

Have you been accepted?______________Intended major ________________________________

What do you plan to do after college? ______________________________________________

______________________________________________________________________________________

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List Major School ActivitiesPosition held
_____________________________________ _____________________________
_____________________________________ _____________________________
_____________________________________ _____________________________
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List Community ActivitiesPosition held
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List Work ExperiencePosition held
__________________________________________________________________
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List honors that have been awarded to you

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

Please attach an essay in your own handwriting, explaining your educational objectives and aims in life. Limit it to 300 words.

Applicant Signature_______________________________________________________


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