Triangle Employee Dependent Undergrad Scholarship Application

Applicant's Name:

Address:

City:

State:

Zip:

Parent or Legal Guardian Name:

Phone Number:

E-Mail:

Confirm E-Mail:

Triangle Account Number:

High School or College GPA:

Did you take the ACT or SAT: ACT SAT

ACT or SAT Score:

Activities in School:

Leadership Experience in School:

Activities in Community:

Employment History:

Volunteer History:

Personal Statement: (2100 chars left)

Attach the requested items below.

Copy of most recent transcript:

Copy of most recent grade report if not included on transcript:

Copy of ACT or SAT score report

Terms & Conditions

I certify that all information is true and provided in good faith.

I understand that I am responsible for following up with my chosen evaluator to ensure the E-Value-Ation form is submitted before April 1st.

I agree to the above Terms & Conditions:

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