GTCC CORPORATE AND CONTINUING EDUCATION SCHOLARSHIP
APPLICATION
ACADEMIC YEAR 2019-2020
List the program or specific course number for which you wish to apply
Full Name of Scholarship Applicant
Address
Phone
E-Mail
Target Group Affiliation (Check all that apply)
Gender
Unemployed /
Underemployed Adult
Provide Printout from
NCWorks
NC National
Guard Member
Provide
Verification
from Unit
Command
Military Veteran
or Spouse
Provide DD214
or DD2
Underserved Populations: Specific
Workforce Sector or Area
Specify:_____________________
Female
Male
Current Employment
Status
Ethnicity
Unemployed
African American
Hawaiian/Pacific Islander
Non-Hispanic/Latino
Underemployed*
American/Alaskan Native
Hispanic/Latino
White/Caucasian
Employed Full-Time
Asian
List your monthly income
How many people are you financial responsible
for in your household?
From which school did you receive your High
School diploma or GED?
How would you pay for the course(s) if you do
not receive the scholarship?
List any other Scholarships you have applied to
receive?
Do you plan to enroll in further training?
If yes, what future training do you plan to seek?
On an additional page, briefly explain your career objectives/goals and why you are requesting
financial assistance to help meet them?
Student Signature:
Email completed applications to: mtladue@gtcc.edu
Updated: July 5, 2019
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signature
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