EXMOOR FOUNDATION SCHOLARSHIP FORM

* Last Name:

* First Name:

Middle Name:

Nickname:

* Date:

Please select one:

New Applicant

Returning Exmoor Foundation Scholar

Check One:

Home Address:

City:

State:

Zip:

Email:

Cell Phone:

Date of Birth:

Area where you work at Exmoor (i.e. caddie, grounds crew, wait staff, lifeguard, administrative):

How many years have you worked at Exmoor?

If you do not work at Exmoor CC, what is your current employer and position, if any?

If your family member works at Exmoor CC, what is their name and your relationship to them?

If your family member works at Exmoor, what area?

How many years has your family member worked at Exmoor CC?

Please complete if the applicant is a minor and not a family member of an Exmoor employee, if not, please proceed to the below section to complete the application.

Parent(s)/Guardian(s) Name:

Employer:

Occupation:

Name of School you are attending:

Location of School:

Student ID #

Last 4 Digits of SSN

What school do you wish to attend?

Post-Secondary Academic

Vocational/Trade

College Preparatory High School

What year will you be (Freshman, Sophomore, Junior, Senior, Grad Student)?

High School Grade Level or College Level for 2024- 2025:

ACT Score (if applicable):

SAT Score (if applicable):

If applicable: Major or intended field of study in college:

List Scholarship awards received:

Please list your anticipated out- of- pocket expense after any scholarships and/or awards received for the 2024-2025 shool year:

List or attach Athletic/Team activities, Music/Arts/Theater activities, and other Activities/Clubs and please include any leadership positions and/or awards received:

List Non-School activities including volunteer, part-time or full-time jobs:

* Denotes Required Field