Produced by LCCC Public Relations PRS 9055 9/09
Restaino Family Memorial
SCHOLARSHIP APPLICATION FORM
Scholarship Criteria:
1. The student shall enroll as a full-time or part-time student taking a minimum
six credit hours.
2. The student shall have financial need as determined by the LCCC Financial
Aid Office.
3. The student shall be a Wyoming resident.
4. The student shall maintain a minimum of a 3.0 grade point average.
5. The student shall be attending classes on the Cheyenne campus, including
on-line classes.
6. The student will have a declared major in medical field or education.
Application Process:
1. Please attach a paragraph describing your educational goals, career goals and
why you have financial need.
Application Deadline: April 1
Name Phone
Address
Street
City, State, ZIP
By checking this box, I hereby certify the provided information is accurate to the
best of my knowledge. I also certify that I will allow the Scholarship and Financial
Aid Office at LCCC to release any information that is applicable to this application.
__________________________________________________ _____________________
Name Date
Essay
Submission Instructions
Submit application before April 1
Please note the pop-up window that appears after you click
Submit.
1. e window will ask you to select your email client.
2. If you use Microsoft Outlook Express, Microsoft
Outlook, Eudora or Mail, click “OK” in the pop-up
window. e form will be emailed to us.
3. If you use any other client, such as Yahoo or Hotmail,
choose “Internet Email,” then click “OK.
• ecomputerwillsavetheformtoyourharddrive.
• Openyouremailaccount.
• Attachtheformtoamessageandemailitto
FinancialAid@lccc.wy.edu.
4. PleasecontactFinancialAidat307.778.1156tomake
suretheformwasreceivedsuccessfully.
SUBMIT
or
PRINT
andmailto: LaramieCountyCommunityCollege
Scholarship&FinancialAidOce
1400E.CollegeDrive
Cheyenne,WY82007