HUDSON VALLEY COMMUNITY COLLEGE SCHOLARSHIP APPLICATION
FOR STUDENTS ENROLLED IN THE COLLEGE IN THE HIGH SCHOOL
To receive consideration, all applications must be signed by a high school official certifying eligibility of the student.
Street Address Village/Town/City
State Zip County
Email: _______________________________________________ Telephone Number: _______________________________________________
HVCC ID# or SSN: ______________________________________________________________________________________________________
Applicant’s Signature: ____________________________________________________________________ Date __________________________
High School Attending: __________________________________________________________________________________________________
I understand that the Hudson Valley Community College Foundation Scholarship Committee and donors may review my academic records in order to determine my eligibility for
scholarships, including my Grade Point Average, Federal Application for Student Aid and, in the case of international students, a Financial Needs Assessment form which should be
completed and filed with the Financial Aid Office. I hereby authorize the review of these records for such purposes. Unless I have a FERPA hold on file with the college, I understand
and give my consent to the following:
• Listing the criteria and non-directory information about me that has made me eligible for this scholarship in any articles, press releases or other publications about
Hudson Valley Community College or the Foundation and the scholarship award.
• The use of my picture in such articles, press releases or other publications.
By submitting this application, I verify that the information provided is true and accurate. I understand that Foundation policy states that students found to have falsified information
on their application will lose their eligibility.
HIGH SCHOOL STUDENTS:
Applications must be received no later than:
March 11, 2021
If hand-delivered, scholarship applications must be received by 4 p.m. on the day they are due. Incomplete applications will not be considered.
SCHOLARSHIP APPLICATIONS MUST BE
EMAILED BY A SCHOOL OFFICIAL TO:
Signature of Official Certifying Eligibility Date
for Federal Free Lunch Program
Hudson Valley Community College does not discriminate on the basis of age,
gender, race or ethnicity, national origin, religion, disabling condition, marital
status or sexual orientation. If you have a disability and require any reasonable
accommodations, or an interpreter, please contact the Center for Access
and Assistive Technology at (518) 629-7154 or TDD (518) 629-7596.
A State University of New York college
Sponsored by Rensselaer County
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