NJACAC
PO BOX 1038
Tuckerton, NJ 08087

STUDENT SCHOLARSHIP APPLICATION         for the 2008-09 school year

(Please check one category)
 
_____ Graduating high school senior who will be enrolled as a full time college freshman
 
_____ Community college sophomore who will be enrolled at an accredited four-year college
 
Name________________________________________Social Security #___ ___  _____
            Last                             First                        Middle
 
Mailing address_____________________________City_______________________
 
State_____Zip______ Telephone (      ) ___________________________________
 
Birth Date__________________  Place of birth____________________________
 
Secondary School name_____________________________________________
 
Full School address________________________________ City_______Zip______
 
Graduation date_____________   College planning to attend_______________
 
Community college name____________________________________________
 
Degree name____________________    Transferring to______________________
 
 
Are you a New Jersey resident?       Yes       No
 
Are you a United States Citizen?     Yes      No
 
I certify that the information provided is correct
 
_______________________________________  ______________________________
Applicant signature                                         Parent signature if student under 18 years
 
School counselor or community college admission representative must be a member of NJACAC (Legible signature)__________________________________________
After April 9 names of winners will be found on the NJACAC web site- Fully completed applications and required documents must be received, in a single envelope, by March l. 
Send to NJACAC Scholarship Committee, c/o Mrs. Stickney, P O Box 1038
Tuckerton, NJ 08087. For further information:  www.NJACAC.COM/scholarship.htm