West Virginia Rural Water Association

100 Young Street

Scott Depot, WV  25560

1-800-339-4513

1-304-201-1694 (fax)

 

All responses must be typed in their appropriate response box.  All response boxes must be completed.  If the item is not applicable place a N/A in the corresponding box.  Applications that are not filled out completely will not be considered.  Please read the official rules below carefully.

 

 

E-mail Address: *
Personal Data
Last Name *
First Name *
Middle Name *
Address *
City *
State *
Zip Code *
Social Security Number *
Telephone Number *
Eligible System Employee Data
Name *
Job Title *
Address *
City *
State *
Zip Code *
System *
Telephone *
Relationship to Applicant *
High School Data
School Name *
Graduation Date *
School Address *
School City *
School State *
School Zip Code *
Your Class Rank *
Number of students in class *
Your Grade Point Average *
List any academic awards, memberships, or other special recognition you have received dating back to your sophmore year
College/University Data
Is this your first year of higher education *
If no indicate credit hours required to graduate
Number of credit hours required to graduate
College Grade Point Average
School Name
School Address
School City
School State
School Zip Code
Please indicate.....
Major Course of Study
Financial Data
If you are receiving other financial aid please itemize by name and amount:
If there are any family circumstances that shall influence your need for financial assistance, please describe:
Essay
In 250 words or less, write a brief essay on your goals as they relate to your education, career, and future plans: *
Applicants Signature/Date
Parents Signature/Date
Verification Code:
Enter Verification Code: *
* Required

* Required

Official Rules

This grant of One Thousand Dollars ($1,000.00) will be made to a student to defray the cost of tuition, books, or room and board at an accredited institution of higher learning approved by the West Virginia Rural Water Association (WVRWA).  Disbursement of the money will be made upon presentation of winner's college or university invoice as proof of full-time enrollment.  The scholarship money will be paid directly to the student, Five Hundred ($500.00) per semester or divided quarterly.  The scholarships will be awarded to children or stepchildren of WVRWA voting member full-time system employees; students must be 26 or under by September 1 of that school year.  In order to be eligible for a scholarship, applicants must complete the application form in its entirety by completing all blanks.. If item is not applicable please place a N/A in the blank.  Upon completion return it to the WVRWA Scholarship Committee by the entry deadline of March 1, 2007.  All applicants will be first screened on the basis of leadership responsibilities in community and school activities as well as grade point average.  The scholarship recipients will be selected on the basis of the number, length of commitment, and quality of leadership responsibilities in community and school activities, awards, honors, academic record, career goals, and financial need.  Applicants will be evaluated on a comparative basis at the sole discretion of the committee.  Decisions will be final.  Application material and decisions of the committee shall be confidential.  Acceptance of scholarship constitutes permission to use recipients name and/or likeness for purpose of promotion.