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2013-2014
Scholarships
How to apply . . . .
1.
SELECT the scholarships for which you meet the criteria.
2.
COMPLETE the application form (on back).
3.
WRITE a 150-word essay on yourself and your educational goals. Be sure to include career interest, extracurricular activities, volunteer experience and any other information that distinguishes you.
4.
PROVIDE necessary academic records. (High School seniors need official transcript and ACT scores. College students need official college transcripts.) All applicants will need at least one letter of recommendation from an instructor or counselor. (Some scholarships require two letters.)
5.
MAIL or BRING your application and required documents to:
LCCC Foundation Office
Erickson 211
5800 Godfrey Road
Godfrey IL 62035
APPLICATIONS WILL NOT BE ACCEPTED AT OTHER LOCATIONS
DEADLINE: 4:30 p.m., Friday, April 5, 2013
Application deadlines differ for GED Distinguished scholarships and Joy L. Eisenreich Scholarship for
Dental Assisting and are noted inside the packet.
Scholarship Facts
Endowed scholarships are available every year. Annual scholarships are only awarded when funds are available.
Scholarships are for fall and spring semesters only (There are no summer scholarships). All scholarships are non
transferable to a different academic year other than the year awarded. All scholarships are non transferable to any
institution other than Lewis and Clark Community College. Those scholarships that cover textbooks and supplies only
cover those items purchased at the College Bookstore of America located on Lewis and Clark Community College
campus.
Scholarship Criteria And Terms
Donors may establish criteria for scholarships. A brief summary of current scholarship criteria is found in this guide.
Many Foundation scholarships are designated for particular groups of students. Scholarships may be restricted by
geographic area, field of study, or to students with special needs. The “Scholarship Opportunities” section in this guide
will provide a preview. The Illinois Student Assistance Commission Monetary Award Program will be referred to in
this publication as the MAP Grant.
NOTE: The number and award amount of Foundation scholarships may vary from year to year.
General Scholarships
The Edward & Lois Davis Scholarship (1 Endowed)
• AWARD - $600 ($300 per semester) for tuition, fees, books and/or supplies.
• Applicant must be a graduate of Alton, Marquette, Roxana, East Alton/Wood River or Jersey
Community High Schools.
• Applicant must be a resident of LCCC District # 536.
• Applicant must enroll full-time.
• Applicants must remain in good standing.
• Students receiving the MAP Grant and/or Pell Grant are eligible for this award.
• Students who have received this award previously are eligible to apply for a second award.
Judge Philip J. Kardis Scholarship (1 Endowed)
• AWARD - $600 ($300 per semester) for tuition, fees, and/or books, until graduation or completion of the program.
• Applicant must reside in Alton or Godfrey.
• Applicant must have graduated from Alton Senior High School with at least a “B” average.
• Applicant may enroll either part-time or full-time.
• This scholarship will fund expenses not covered by other Federal or State financial aid.
The Roberts Motors, Inc. Scholarship (2 Endowed)
• AWARD - $1,600 ($800 per semester) for tuition, fees, books and/or supplies.
• Applicant must be a resident of LCCC District # 536.
• Applicant must have a “B” average or equivalent GPA.
• Applicant may enroll part-time or full-time.
• Students receiving the MAP Grant or Pell Grant are eligible.
Lewis and Clark Community College Alumni Association Scholarship (2 Annual)
• AWARD - $700 ($350 per semester) for tuition and fees.
• Applicant must enroll full-time.
• Applicant must have completed 28 hours at LCCC with a 2.5 GPA or higher.
• Recipients may receive the Pell grant. Students receiving the MAP Grant for full tuition and fees will not be eligible for this scholarship. If partial MAP Grant is received, remaining tuition and fees are eligible.
The Larry D. Underwood Scholarship (1 Annual)
• AWARD - $500 ($250 per semester) for tuition, fees and/or books.
• Applicant must be a graduate of Brussels High School with a GPA of at least 3.0 (B)
• Applicant must enroll as a full-time LCCC student.
• Prefer middle income student.
• Prefer student majoring in History/Liberal Arts.
• Student may receive this award for two semesters only – it is not renewable.
Post Baccalaureate Associate Degree Career Scholarship (1 Annual)
• AWARD – All tuition and fees required for the program chosen.
• Applicant must provide proof of a Bachelors Degree.
• Applicant must be pursuing an Associate of Applied Science Degree in a Lewis and Clark Career Program.
• Applicant must enroll in at least 6 hours.
• Applicant must have a GPA of 2.5 or higher on a 4.0 scale.
• Applicant may not receive any other waivers or scholarships that pay for tuition and fees only.
• Recipients of this scholarship can reapply for each academic year.
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Lewis and Clark Community College Foundation Sophomore Distinguished
Scholars Award (1 Annual)
• AWARD - All tuition and fees.
• Applicant must enroll full-time.
• Applicant must have completed 28 college credit hours with a cumulative GPA of 3.0 or higher.
• Transferring, re-entering or re-admitting students may apply for this award.
• Award cannot be used in conjunction with other LCCC Foundation scholarships.
• Recipients may receive the Pell grant. Students receiving the MAP Grant for full tuition and fees will not be eligible for this scholarship. If partial MAP Grant is received, remaining tuition and fees are eligible.
Business and Accounting Scholarships
The Edward Schriefer Memorial Scholarship (1 Annual)
• AWARD – $750 ($375 per semester) for tuition, fees, books and/or supplies.
• Applicant must have at least a 2.5 GPA and have completed 18 semester hours.
• Applicant must major in Accounting.
• Applicant must be a resident of LCCC District #536.
• Applicant may enroll part-time or full-time.
• Students receiving the MAP and/or Pell grant are eligible for this award.
The J. Thomas Long Family Scholarship for Business Students (1 Annual)
• AWARD – Tuition and fees (up to 16 hours per semester for two semesters).
• Applicant must reside in Godfrey, Alton or Fosterburg Townships.
• Applicant must be a high school senior with at least a “B” average.
• Applicant must major in Business.
• Applicant must enroll full-time.
• Renewable for a second year if a 3.0 or higher GPA has been maintained during freshman year at L&C.
• Students may receive the Pell grant. Students receiving the MAP grant for full tuition and fees will not be eligible. If partial MAP is received, remaining tuition and fees are eligible.
Education Scholarship
Edna Sawyer Memorial Scholarship (2 Endowed)
• AWARD – $1,600 ($800 per semester) for tuition and fees.
• Applicant must be an education major, planning to enter the teaching profession.
• Applicant may enroll either part-time or full-time.
• Students may receive the Pell grant. Students receiving the MAP Grant for full tuition and fees will not be
eligible for this scholarship. If partial MAP grant is received, remaining tuition and fees are eligible
Radio Broadcasting Scholarship
The Talley Broadcasting Corporation Scholarship (1 Annual)
AWARD - $250 for fall semester for books and supplies related to the Radio Broadcasting program at Lewis and Clark.
• Applicant must be enrolled in the Radio Broadcasting Program.
• Applicant must be in good academic standing.
• Applicant must remain enrolled throughout the semester the award is given.
• Preference to a student who is studying all aspects of radio broadcasting, and not necessarily focused on solely becoming a disc jockey or on-air talent.
•
Sports Scholarship
Dr. Raymond R. Simpson Memorial Scholarship for Men’s Tennis (Endowed)
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• Contact the Athletic Director for an application form.
Math Scholarship
The Jack Stankoven Math Scholarship (3 Annual)
• AWARD – $100 for tuition, fees, books, calculators or direct development level Math course expenses.
• Applicant must be enrolled in a developmental level Math course. (Math 111, 112, or 116)
• Applicant may enroll either part-time or full-time.
• Applicant may receive the Pell or MAP grants.
High School Senior Scholarships
Brad Lakin, Kyra Lakin, Kris Lakin and Karey Lakin Scholarship for Students at
Roxana and East Alton/Wood River High Schools (2 Endowed)
• AWARD - $1,000 ($500 per semester) for tuition, fees and/or books.
• Applicant must be a high school senior graduating from either Roxana High School or East Alton/Wood River High School and reside in Roxana or East Alton/Wood River District.
• Applicant must have a “C” average or better.
• Applicant may enroll either part-time or full-time.
• Applicant must be Pell eligible.
• Students receiving the MAP Grant and/or Pell Grant are eligible for this award.
The Robert R. & Verna F. Werts Scholarship (1 Endowed)
• AWARD - $650 ($325 per semester) for tuition, fees, or books.
• Applicant must be a resident of LCCC District # 536.
• Applicant must be a high school senior with a “C” average or better.
• Applicant may enroll part-time or full-time.
• A student who has received this award previously may reapply.
• Career program majors are a preference.
• Recipients must remain in satisfactory academic status to receive a full award: no academic or
behavioral probation.
Wanita E. and Wilbur R.L. Trimpe Memorial Scholarship (1 Endowed)
• AWARD - $500 ($250 per semester) for tuition, fees and/or books.
• Applicant must be a high school senior graduating from Civic Memorial High School and residing within the Bethalto Community School District.
• Applicants related to any member of the Bethalto Community Unit School board, any member of the LCCC Board of Trustees or any member of the selection committee cannot receive this award.
• Applicant must have a “C” average or better.
• Applicant must enroll full-time.
• Applicant must provide evidence of extra-curricular activities dedicated to the service of others.
• Scholarship is renewable for a second year if “C” average is maintained.
• Recipients may receive the Pell grant. Students receiving the MAP Grant for full tuition and fees will not be eligible for this scholarship. If partial MAP Grant is received, remaining tuition and fees are eligible.
The Jordan C. Klope Memorial Scholarship (1 Annual)
• AWARD -$1,000 ($500 per semester) for tuition, fees and/or books and supplies.
• The applicant must be a graduating high school senior and live in the Lewis and Clark District #536
• The applicant must be enrolled full time at Lewis and Clark Community College
• It is preferred the applicant is part of a youth trap team and a member of the Scholastic Clay Target Program (SCTP) and the Amateur Trapshooting Association (ATA). The applicant must provide proof of
membership with their application.
• The applicant must have a minimum GPA of 3.0
• The applicant may receive other financial assistance, such as Pell & MAP grants. Any other financial
assistance received will be applied to the student’s account first.
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Lewis and Clark Community College Foundation Distinguished Scholars Award
(Number of annual scholarships will vary.)
• AWARD - All tuition and fees.
• Applicant must enroll full-time.
• Applicant must be a Lewis and Clark District high school senior who will graduate in the top 10% of
his/her class.
• Scholarship is renewable each semester if 3.0 GPA maintained.
• Recipients may receive the Pell grant. Students receiving the MAP Grant for full tuition and fees will not be eligible for this scholarship. If partial MAP Grant is received, remaining tuition and fees are eligible.
Golden Eagle Scholars Award (Number of annual scholarships will vary.)
• AWARD - All tuition and fees for fall and spring semesters.
• This is a one year award for fall and spring semesters immediately following graduation from high school.
• Applicant must enroll full-time.
• Applicant must be a Lewis and Clark District high school senior who will graduate in the top 11-20% of his/her class.
• Scholarship cannot be used in conjunction with any other LCCC Foundation tuition scholarship.
• Recipients may receive the Pell grant. Students receiving the MAP Grant for full tuition and fees will not be eligible for this scholarship. If partial MAP Grant is received, remaining tuition and fees are eligible.
Music Scholarships
The Crane Piano Scholarship (1 Annual)
• AWARD – pays for applied piano instruction for one semester.
• Applicant must be a music major at LCCC, with piano as the student’s primary instrument.
• Applicant must maintain a “B” average in their declared major.
• Applicant must maintain an overall 3.0 GPA.
• Applicant must audition in the spring semester to receive the award in the following academic year.
• Applicant may reapply and audition for a second award as long as all criteria are met.
• Applicant is reviewed and selected by the Music department.
The Piasa Charitable Foundation Music Scholarship (1 Annual)
• AWARD - $1,000 ($500 per semester) for tuition, fees, books and/or supplies related to the music program.
• Applicant must be a declared music major (AFA/AAAFA) at Lewis and Clark Community College and must remain so for the duration of the scholarship.
• Applicant must audition in the spring prior to the awarded semester.
• Applicant must be enrolled as a full-time student (a minimum of 12 hours.)
• Applicant must maintain a 3.0 GPA in major area and an overall 2.5 or higher GPA.
• This scholarship is renewable for a second year provided the required criteria are met.
GED Scholarship
Lewis and Clark Community College Foundation GED Distinguished Scholars
Award (1 Annual)
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• AWARD - All tuition and fees for fall and spring semesters.
• Applicant may enroll part-time or full-time.
• Applicant must have a minimum score of 3000 on General Education Development Test and reside in the LCCC District #536.
• GED test must have been taken within one year prior to date of application.
• Documentation of GED scores must be submitted.
• Scholarship is renewable for the next year with a 2.5 minimum GPA.
• Recipients may receive the Pell grant. Students receiving the MAP Grant for full tuition and fees will not be eligible for this scholarship. If partial MAP Grant is received, remaining tuition and fees are eligible.
Deadline for applications for this award only are the third Friday in May and the second
Friday in December.
Scholarships for Females Only
Godfrey Women’s Club Scholarship (1 Annual)
• AWARD – $2000 ($1000 per semester) for tuition, fees, books and/or supplies.
• Applicant must be a female resident of Godfrey with the zip code of 62035.
• Applicant must be 18 years of age or older.
• Applicant may enroll part-time or full-time.
• Students receiving the MAP will not be eligible but students receiving the Pell grant are eligible for this award.
Marlene Barach Scholarship for Women (1 Endowed)
• AWARD – $600 ($300 per semester) for tuition, fees, books and/or supplies associated with the
program curricula.
• Applicant must be a female, 25 years of age or older and reside in LCCC District #536.
• Applicant may be a first-time student or returning student.
• Applicant may enroll part-time or full-time.
• Students receiving the MAP and/or Pell grant are eligible for this award.
Monticello Scholarship for Deserving Women (1 Endowed)
• AWARD – $2,300 ($1,150 per semester) for tuition, fees, books and/or supplies.
• Applicant must be a female and must enroll in at least 6 credit hours.
• Applicant must maintain a GPA of 3.0.
• Students receiving the MAP and/or Pell grant are eligible for this award.
Postlewait-Brunjes Scholarship of the Alton Area (1 Endowed)
• AWARD – $600 ($300 per semester) for tuition, fees, books and/or supplies.
• Applicant must be a female LCCC District #536 high school senior.
• Applicant may enroll part-time or full-time.
• Students receiving the MAP and/or Pell grant are eligible for this award.
• Applications may be reviewed by the Alton BPW.
Postlewait-Brunjes Scholarship of the Alton Area (1 Endowed)
• AWARD – $600 ($300 per semester) for tuition, fees, books and/or supplies.
• Applicant must be a female, 25 years of age or over who is entering or re-entering the workforce or who is seeking to improve her position.
• Applicant may enroll part-time or full-time.
• Students receiving the MAP and/or Pell grant are eligible for this award.
• Applications may be reviewed by the Alton BPW.
Zonta Club of Alton-Wood River Scholarship (1 Annual)
• AWARD – $1,000 ($500 per semester) for tuition, fees or books and supplies.
• Applicant must be a female, non-traditional student who is re-admitting or returning.
• Applicant must reside in LCCC District # 536.
• Applicant may enroll part-time or full-time.
• Previous recipients with a GPA of 3.0 or higher may reapply for this award.
• Students receiving the MAP and/or Pell grant are eligible for this award.
Single Parent Scholarship
The Darrell & Lynn (Varner) Yearwood Scholarship (1 Annual)
• AWARD - $500 ($250 per semester) for tuition, fees or books.
• Applicant must have completed at least 30 hours but not more than 60 hours with at least a 3.25 GPA.
• Applicant must be at least 30 years of age.
• Applicant must be the single head of the household with children at home.
• Applicant must enroll in a minimum of 6 hours at LCCC.
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Health Sciences Scholarships
Alton Nurses Club Scholarship (Vee Smith Memorial) (1 Endowed)
• AWARD - $500 ($250 per semester) for tuition, fees, books and/or supplies.
• Applicant must have completed two semesters in LCCC Nursing Program. Only those students entering the third semester are eligible.
• Applicant may enroll part-time or full-time, and must show financial need.
• One recommendation letter from the Dean of Health Sciences or Director of Nursing must be submitted.
• Students receiving the MAP Grant and/or the Pell Grant are eligible for this award.
Charles & Carmen Puckett Memorial Scholarship (1 Annual)
• AWARD – $300 for fall semester for textbooks.
• Applicant must be enrolled in a LCCC Health Sciences Program.
• Applicant must have completed 30 hours with a GPA of 3.0 or currently be enrolled in the second
semester of any Health Sciences Program.
• Applicant may enroll part-time or full-time.
• Applications will be reviewed by Professor Emeritus, Paula Holloway, for selection.
• Students receiving the MAP or Pell grant are eligible to receive this award.
Illinois Health Improvement Association Scholarship (2 Annual)
• AWARD – $500 ($250 per semester)for tuition, fees and/or books
• Applicant may enroll part-time or full-time.
• Applicant must be a resident of the State of Illinois.
• Applicant must be enrolled in a Health Care Program that gives direct medical care to individuals.
• Applicant must be committed in his/her intent to practice in Illinois.
• Students receiving the MAP or Pell grant are eligible to receive this award.
The Joy L. Eisenreich Memorial Scholarship for Dental Assisting (1 Annual)
• AWARD – $250 for spring semester for tuition, fees, books and/or supplies.
• Applicant must be enrolled in the Dental Assisting Program.
• Applicant must have completed 18.5 hours of dental courses and be enrolled in the second semester program.
• Applicant must have a minimum GPA of 2.0.
• Applicant must be committed to his/her intent to work as a team member within the dental profession.
• Students receiving the MAP or Pell grant are eligible to receive this award.
• The student will be nominated by a Dental Assisting program faculty member based on fall semester academic performance, laboratory proficiency and professionalism.
• The nominations are reviewed and chosen by members of the DA/DH Advisory Committee and the Dental Assisting program coordinator. Contact the Dental Assisting Department for deadlines.
Occupational Therapy Assistant Scholarship (2 Annual)
• AWARD – $350 ($175 per semester) tuition, fees, books and/or supplies associated with the program.
• Applicant must be enrolled full-time in the OTA Program and be in the 2nd, 3rd or 4th semester.
• Students receiving the MAP or Pell grant are eligible to receive this award.
Mildred L. Thompson Scholarship for Nursing Students (1 Endowed)
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• AWARD - $500 ($250 per semester). The award may be used for tuition, fees, books and/or supplies specifically related to the nursing program.
• Applicants may be part-time or full-time students.
• Applicant must have completed two semesters in the Nursing Program to receive this award. Two recommendation letters must be submitted – one from the Director of Nursing and the second from a member of the nursing program faculty.
• Applicants must have a 3.0 or higher GPA. Applicants receiving the MAP or Pell grants MAY apply for a textbook scholarship from this fund.
The O’Neil Family Scholarship (1 Annual)
• AWARD – $1,000 ($500 per semester) for tuition, fees and/or books.
• Applicant must have been accepted into the Nursing Program.
• Applicant must be a resident of Lewis and Clark Community College District #536.
• Applicant must be in good academic standing.
• Applicant must remain enrolled throughout each semester.
• Applicants who qualify for repayable loan programs are eligible.
• Eligible students must not qualify for non-repayable grants, scholarships or tuition assistance from any source.
• Applicants are reviewed and chosen by the Nursing Department.
The Outstanding A & P Student Scholarship (1 each semester)
• AWARD – $300 to be awarded at the end of the fall semester to be used for tuition or books in the spring semester. $300 to be awarded at the end of the spring semester to be used for tuition or books for the fall semester.
• Applicant must demonstrate outstanding performance in Anatomy and Physiology I during the semester at LCCC. This includes earning an “A” in the course, outstanding attendance, and an ability to apply facts to practical situations, as observed by the instructor.
• Applicant must be enrolled in the ADN, OTA, DH, Therapeutic Massage or Exercise Science Programs.
• Applicant may be enrolled either part-time or full-time.
• Applicant will be nominated and chosen by their A & P Instructor.
The Virginia Cramblet, R.N., Memorial Scholarship for Nursing Students
(1 Endowed)
• AWARD – $1,000 ($500 per semester) for tuition, fees, books and/or supplies available through the
college bookstore.
• Applicant must have completed one semester in the nursing program and have met all of the
requirements for that semester of the Nursing Program, prior to the award disbursement.
• Student may enroll part-time or full-time.
• Students receiving the MAP or Pell Grant are eligible for this scholarship.
• Recommendation letter from either LC Nursing Faculty or Director of Nursing must be submitted.
The Theresa D. Finkes Nursing Scholarship (2 Annual)
• AWARD – $500 ($250 per semester) for tuition and fees.
• Applicant must be entering the third semester of the Nursing Program.
• Applicant may be enrolled either part-time or full-time.
• Applicant is to be a graduate of Greene or Jersey county schools. In case of no eligible candidates, other counties may be considered.
• Official High School transcript is required to verify Greene or Jersey county eligibility.
• Students receiving the MAP or Pell grant are eligible to receive this award.
Scholarships for Students with Disabilities
The Alton Godfrey Lion’s Club Scholarship (1 Annual)
• AWARD – $500 ($250 per semester) for tuition, fees, books and/or supplies.
• Applicant must enroll in at least 6 credit hours at LCCC.
• Applicant must provide documentation of hearing impairment, visual impairment or diabetes.
• Applicant must maintain a 2.0 average. (Award will be made at the end of the semester.)
• Students receiving the MAP and/or Pell grant are eligible for this award.
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The Jack and Irene Reed Memorial Scholarship for the Visually Impaired
(1 Endowed)
• AWARD – $500 ($250 per semester) for tuition, fees and/or books.
• Applicant must live in LCCC District #536. Applicant may enroll either part-time or full-time.
• Applicant must be legally, visually impaired and must have written documentation of the visual impairment.
• Students receiving the MAP and/or Pell grant are eligible for this award.
Myrtle & Virgil Jacoby Scholarship (1 Endowed)
• AWARD – $2,750 ($1,375 per semester) for tuition, fees and/or books.
• Applicant must be physically disabled.
• Applicant may enroll part-time or full-time.
• Students receiving the MAP and/or Pell grant are eligible for this award.
Environmental Scholarship
The Brookfield Renewable Power Scholarship (1 Endowed)
• AWARD - $800 ($400 per semester) for tuition, fees or intern-related expenses.
• Applicant must be registered at Lewis and Clark and be engaged in river studies at the National Great Rivers Research and Education Center’s Field Station. NGRREC interns may apply.
• This scholarship is a one-time award and is non-renewable.
• Student must maintain an overall “B” average.
• Recipients of the scholarship shall send Brookfield a letter after their experience which will include a description of their experience and a brief background on themselves.
The Robert McClellan Sustainability Scholarship (1 Endowed)
• AWARD - $700 ($350 per semester) for tuition and fees.
• The applicant must be studying in a program related to sustainability practices.
• The applicant may enroll full time or part time.
• The student must remain in good standing
The James & Aune Nelson Foundation Sustainability Scholarship (1 Annual)
• AWARD - Tuition and fees for fall and spring semester
• The applicant must be studying in a program related to sustainability practices.
• The applicant may enroll full time or part time.
• The student must remain in good standing.
Process Operations Technology Scholarship
ConocoPhillips Scholarship (1 Annual)
• AWARD - $500 ($250 per semester) for tuition, fees and/or textbooks and supplies associated with the
Process Operations program at Lewis and Clark
• Applicant may enroll part-time or full-time
• Applicant must reside in LCCC District #536
• Applicants must have a 3.0 GPA
• Students receiving MAP and/or PELL Grant are eligible for this award
ConocoPhillips PTEC Minority Scholarship (1 Annual)
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• AWARD - $3,000 ($1,500 per semester) for tuition, fees, and/or books and supplies associated with the Process Operations program at Lewis and Clark Community College.
• Applicant may enroll full time or part time.
• Applicant must be a minority.
• Applicant must currently be a senior in high school or a freshman in college and 21 years of age or younger.
• Applicant must have a GPA of 2.85 or higher.
• Applicant must continue the entire academic year without interruption.
• Students receiving other financial aid, such as MAP and/or PELL grants are eligible for this award.
• Contact the Foundation office to apply for this scholarship.
Scholarship
Application
To be considered for a Foundation scholarship, you must submit a completed application package which
includes the following:
1.
A completed scholarship application listing all scholarships for which you wish to apply.
2.
OFFICIAL high school transcript, including documentation of ACT Scores OR OFFICIAL college transcript(s); whichever pertains to you.
Concise statement (150 words) on yourself and educational goals. Be sure to include career interest, extracurricular activities, volunteer experience and any other information that distinguishes you.
All documents and/or information required by a particular scholarship.
All applicants are required to submit at least one recommendation letter. Some scholarships require
additional letters
3.
4.
5.
A complete application package should be received no later than Friday, April 5, 2013* by 4:30 p.m. in the
LCCC Foundation Office, Erickson 211, 5800 Godfrey Road, Godfrey, IL 62035. Telephone: (6l8) 468-2011. Some scholarships may require additional forms.
**APPLICATIONS WILL NOT BE ACCEPTED AT OTHER LOCATIONS.**
*GED Distinguished Scholar and Joy L. Eisenreich Scholarship for Dental Assisting applicants – refer to the
deadline listed with each scholarship enclosed in this packet for deadline.
Please print or type. Use an additional sheet of paper to list scholarships, if needed.
Application for:
(list scholarships)
Name Email Address: Street
City
Phone: (Day)
Enrollment Intended:
GED Recipient:
State
(Cell)
Full Time
Yes No Zip
County
(Evening) Part Time
GED Test Date:
Score:
If current graduating High School Senior:
School Name: Parent’s Names Parent’s Phone (Day) Graduation Date (M/YR) High School Class Rank (must be verified on your transcript) ----over----
High School GPA ACT Score LCCC Program of Study College Credit Hours Completed College GPA Employed by: Full Time
Part Time
The following questions assist the Foundation in confirming eligibility for specific scholarships.
Responses are voluntary.
Date of birth: Aspire bachelor’s degree?
Self-supporting?
Yes Yes Applying for financial aid?
Disabled?
Yes Female
No
No Single head of household? Yes Male
Yes No
No
No
Type of disability If I am awarded a LCCC Foundation Scholarship, I understand that I must meet LCCC standards of academic
progress. Information from my academic and financial history may be released to the scholarship donor.
Applicant’s Signature Date
For complete details on all financial aid options, please contact the Lewis and Clark Community College
Financial Aid Office.
LCCC Foundation Scholarship Committee reserves the right to screen applicants and make final decisions. All applications will be reviewed and notification of status will be sent to all applicants.
It is the responsibility of the applicant to provide all required documents. Incomplete applications may not be
reviewed by the Scholarship Committee.
Lewis & Clark Community College insures equal opportunities are offered in the admission, education and
employment of individuals regardless of sex, race, ethnicity, color, creed or religion, national origin,
disability, age, marital status, sexual orientation, and other protected categories. Any inquiries concerning the
application of Title VII of the Civil Rights Act, Title IX of the Education Amendments, Section 504 of the
Rehabilitation Act, the Americans with Disabilities Act, the Age Discrimination Act, and the Illinois Human
Rights Act may be made to: Gary Ayres, Vice President of Administration, Erickson Hall, Room 103, Lewis
and Clark Community College, Godfrey IL, 62035 * 618-468-3000.
Completed applications along with essays, transcripts and recommendation letters must be
received in the Foundation Office in Godfrey, ILL, no later than 4:30 p.m., on Friday, April 5,
2013. Applications will not be accepted at any other office or location. You are encouraged to send
your applications in early.
LCCC Foundation Office
Erickson 211
5800 Godfrey Road
Godfrey, IL 62035
Phone number: (618) 468-2011 or (618) 468-3200