Address (Street or P.O. Box) (City) (State) (Zip) Telephone ( ) Birth Date \ \

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Amos Griffin
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1 PERSONAL INFORMATION Name (Last) (First) (Middle) Social Security No. Address (Street or P.O. Box) (City) (State) (Zip) Telephone ( ) Birth Date \ \ Students Address: Parent(s) Address: Class Year Fall, 2018 (circle) COLLEGE INFORMATION Name and address of college at which you have been accepted and will enroll or are currently enrolled: Major Course of study Current grade point average (If High School Senior, List Final GPA) STUDENT CERTIFICATION I am a dependent child of a member or of a deceased member of the Virginia State Police Association. The name of the VSPA member is (Dad or Mom) 1 P age

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3 FINANCIAL AID INFORMATION PARENTS INFORMATION Parent(s) contributing to student s education for school year $ Parent(s) or Legal Guardian name: Relationship: _ Relationship: Name: Occupation: Work Telephone: Name: Occupation: _ Work Telephone: If the applicant expects to receive financial assistance from any other source this academic year, please list the source and the amount below. Please circle whether the expected amount is a loan or a grant. If the applicant is not expecting to receive any assistance, please answer with N/A. Source Amount (Loan or Grant) Source Amount (Loan or Grant) Source Amount (Loan or Grant) Source Amount (Loan or Grant) WRITTEN EXPLANATION OF NEED & GOALS In the applicants own handwriting please explain why you need a scholarship and detail any academic/career goals. 3 P age

4 Please use additional paper if necessary HOUSEHOLD INFORMATION List Family Members living in Household Name of family members Currently in School (Y or N) If yes what grade? Annual Total Household Income (gross income): $ Annual Total Household Expenses: $ Parents Assets: Cash, savings, and checking accounts; $ Parents monthly mortgage or rental payment: $ If own home, provide please: 4 P age

5 Year Purchased: Today Asset value of Home: $ Amount owed: $ For special circumstances please provide on separate sheet with this application. SIGNATURES REQUIRED Student Date: Student s Father: Date: Student s Mother: Date: APPLICATION SUBMISSION This form must be returned to the VSPA office no later than Friday, June 15, If the application is not completely filled out and the transcript is not official, the application will be disqualified. I hereby acknowledge that the information given in this application is true and correct and I also acknowledge that should I leave any questions unanswered my application will be disqualified. Signature of applicant Date TRANSCRIPTS A complete transcript of classes from the most recent year of high school or college must be sent directly from the applicant s school to the VSPA office. If the applicant s official transcript is not received at the VSPA office by Friday, July 13, 2018, the application will be disqualified. 5 P age

6 All applications for scholarships must be received via mail, hand delivery, or PDF by the VSPA Office by 4:00 p.m. on June 15, Completed applications and attachments should be mailed to the VSPA office and addressed as follow: VSPA; Children s Scholarship: 6944 Forest Hill Avenue; Richmond, VA OR ed via PDF to vspa@vspa.org. Incomplete applications will not be considered for scholarship awards. Thank you for applying, and Good Luck! If you have any questions, please contact the VSPA at (804) or vspa@vspa.org. *****MARK YOUR CALENDAR ***** As a scholarship applicant, there are dates you need to know!! Friday, June 15, 2018 Completed application is due back to VSPA by close of business. Friday, July 13, 2018 Official Transcripts ordered from the school are due to VSPA for processing by close of business. Friday, August 10, 2018 The VSPA will make every effort to mail checks to scholarship recipients by this date. 6 P age

7 Friday, February 8, 2019 Fall transcripts are due for 2 nd part of scholarship (Unofficial Transcripts are Acceptable for 2 nd half of the school year) - you may send grades by fax or to vspa@vspa.org 7 P age

STONE COUNTY SCHOLARSHIP APPLICATION The future is the minds of our youth. Strong minds build strong communities.

STONE COUNTY SCHOLARSHIP APPLICATION The future is the minds of our youth. Strong minds build strong communities. Deadline for application is April 13, 2012. Return completed application to your counselor.