Ralph and Edith Apple Presidential Fund Matching Scholarship Award

Application
Name*

First NameLast Name
ECC ID Number*
Date of Birth*

MonthDayYear
Birth Place
State
Address*

Street Address

Street Address Line 2

CityState

ZIP Code
Primary Phone Number*
Please enter a valid phone number.
Secondary Phone Number*
Please enter a valid phone number.
Sex*

MaleFemaleN/AOther
Email*
Marital Status*

SingleMarriedSingle Parent
If custodial parent, list names and ages of children
Ethnicity (Optional)

Black/NonHispanicWhite/NonHispanicAsian/Pacfic IslanderHispanicAmerican Indian/Alaskan NativeOther
Check One*

US CitizenPermanent ResidentVisa HolderDACA
Academic Information
High School Attended
High School Graduation Date

MonthDayYear
High School GPA, if new grad
GED if applicable
Academic Status*

New StudentCurrent/Returning Student
Current Credit Hours Enrolled at ECC*
Total Credit Hours Completed at ECC*
Total Credit Hours Completed Elsewhere*
What is your Major/Area of Interest?*
Will you Enroll in the 2024 - 2025 school year?*

YesNo
How many credit hours will you enroll each semester?
Have you completed a FAFSA*

YesNo
Do you qualify for federal financial aid*

YesNoApplication PendingNot Applying For Federal Aid
How did you learn about opportunities at ECC?*
Signature*

Clear
Date

MonthDayYear
Should be Empty:

Application