2022 Nadine Bryant McMillon Scholarship

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Are you a 2022 Member of CRHS PTSA? *

Yes

Full Name *

Mailing Address *

Phone Number *

Email Address *

Parent's/Guardian's Names *

Parent's/Guardian Phone Number *

List any community service activities in which you have participated and the number of hours logged. (You may include this information as a separate attachment.) *

List your academic achievements, honors, accomplishments and the date(s) received. *

Name and Location of College that you plan to attend *

Planned Program of Study/Major

Share your career goals *

CERTIFICATION

CERTIFICATION

My electronic signature certifies that all the information contained in my application and all requested documentation is complete, factually correct, and honestly presented. I understand that this application packet will be kept confidential and all materials submitted will become the final property of Coral Reef High School PTSA. I understand that any scholarship awards will be revoked if any information contained in the application or any of the documentation is found to be false, plagiarized, or incorrect.

Additionally, should I receive a scholarship, I give consent to Coral Reef High School PTSA to utilize my name, photograph, video, likeness and scholarship award in any publicity material.

I certify that I have read, understand, and will abide by these required rules.

APPLICANT’S EELECTRONIC SIGNATURE/DATE - SEE BELOW.

PARENT/LEGAL GUARDIAN’S SIGNATURE/DATE - SEE BELOW

Applicant's electronic signature and date *

Parent's/Guardian' electronic signature and date *

Use this space to complete any answers that would not fit into a response box or to include any additional details you would like for us to know about you.

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