SPRING 2007

STUDENT INFORMATION (please type or print neatly in ink) DATE _____________________

Name of Applicant___________________________________________________________________

Address ___________________________________________________________________________

City/State/Zip ______________________________________________________________________

Phone Number _________________ Social Security Number _________________________

REASON FOR APPLYING FOR THIS SCHOLARSHIP ______________________________________________________________________________________

______________________________________________________________________________________

(If more space is required, please use the back of this form.)

GPA ____________ Number of total hours accumulated _______________

Year of Graduation __________________ Major __________________________

Signature __________________________________________ Date _______________________

Return completed form by February 2, 2007 to:

The Information Center

Attention: Jewell Whitney

Greenville Technical College