Name
Home Address
Name of Scholarship
Amount of Scholarship
Academic Year
College
Academic Year
Major
Minor
GPA (cumulative)
Anticipated/Actual graduation date?
Honors/Awards
Please tell us how receiving this scholarship affected you and your life.
What has been your greatest success or achievement in college?
If you had to do it all over again, what would you do differently in high school to prepare for college?
Please initial below to give the Community Foundation permission to share your story for marketing purposes on printed materials or on wvcf.com.
Initials
Date