Fillable Form 711: GRANT APPLICATION JUMP START/ACADEMY FOUNDATION OFFICE

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Form 711: GRANT APPLICATION JUMP START/ACADEMY FOUNDATION OFFICE

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JUMP START/ACADEMY
GRANT APPLICATION
FOUNDATION OFFICE
College Drive • P.O. Box 2001
Toms River, NJ 08754-2001
phone
732-255-0492 •
fax
732-864-3876
tty
&
voice
relay
711
Academic Year: Fall _______________ Application Deadline: September 22, 2020
You must be an Ocean County resident.
Social Security Number or OCC Student ID: ___________________________________________________ Date of Birth: _________________________
Name: __________________________________________________________________________________________________________________
Address: _______________________________________________ City: __________________________________ State:_______ Zip: _______
Phone # ________________________________________ Email: ____________________________________________________________________
ACADEMIC INFORMATION
Welcome to Ocean County College and congratulations on choosing to begin your college career while still in high school!
We encourage you to work closely with your School Counselor to ensure you have the best experience possible while
participating in our early college courses at your high school.
High School Attending: ______________________________________________________ High School Year: _______________ Overall GPA: ______
Guidance Counselor Name: __________________________________________________________________________________________________
Parent/Guardian Name: _____________________________________________________________________________________________________
Parent/Guardian Email: _____________________________________________________________________________________________________
Parent/Guardian Address: ___________________________________________________________________________________________________
_______________________________________________________________________________________________________________________
Is your family income under $150,000 a year? Yes No
The Grant Selection Committee would appreciate information about the grant applicant.
The following background information must be provided in order to process your application.
Specific Academic Goals and Career Plans: _________________________________________________________________________________
_______________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________
(If necessary, attach sheet)
continued on next page
Last First MI
Activities Participated in High School: _____________________________________________________________________________________
_____________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________
(If necessary, attach sheet)
Outside Hobbies, Interests, and Activities: ________________________________________________________________________________
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
(If necessary, attach sheet)
Please attach a 250 word essay why you deserve this grant opportunity.
Employer Name & Address (if employed): _________________________________________________________________________________
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
CERTIFICATION: I certify that the information on this application and accompanying documents is true and accurate.
I authorize Ocean County College to release admission, enrollment, academic transcripts, and financial aid information to
the Foundation solely to determine my eligibility for a scholarship.
The Foundation will not promise a grant if I receive financial aid that fully funds my educational expenses.
______________________________________________________________________________________________________________________
Applicant’s Signature Date
______________________________________________________________________________________________________________________
Parent/Guardian's Signature Date
Email completed application to: occadmissions@ocean.edu
Grant recipients will be notified immediately following Committee review.
For further information, please call the OCC Foundation oice at 732-255-0492.
Revised July 2020
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Form 711: GRANT APPLICATION JUMP STARTACADEMY FOUNDATION OFFICE

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Completed 13 October 2020

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