Instructions for Submitting this Application:
• Type your full name, LCCC Student ID # and date in the appropriate boxes below.
Electronic Signature ________________________________________________________________
Please type your First and Last Name
IunderstandthatcheckingthisboxconstitutesalegalsignatureconrmingthatIacknowledgeandwarrantthe
truthfulness of the information provided in this document. I hereby authorize Lehigh Carbon Community College to use
the information provided on this application to determine my scholarship eligibility. I also authorize use of my name and
picture as a scholarship recipient in press releases and/or LCCC publications.
LCCC Student ID #: _______________________________________________
Submittal Date: _________________________________________________
Download and save the application.
Email the completed application to foundation@lccc.edu with “SEED Summer Bridge” in the subject line.
Or
Mail the completed application to:
LCCC Foundation
SEED Summer Bridge
4525 Education Park Drive, Schnecksville, PA 18078
Incomplete applications will not be reviewed. If you require assistance, contact 610-799-1154 or disability@lccc.edu.
*College employees receiving the tuition waiver benefit for themselves, spouses, and legal dependents and individuals who are or
who have previously been legal dependents (while the administrator was employed by the College) for courses taken at the College
will not be eligible for any Lehigh Carbon Community College scholarship funding.
Thank you for your submission of the SEED Scholarship application. As one of the criteria for the grant money we received
providing for these scholarships, we must report on the number of individuals who received scholarships in the low to moderate
income levels. We ask for your assistance in completing this additional chart and returning it as soon as possible. All information
will be kept condential. This is solely for reporting purposes back to our grantor.
HOUSEHOLD AND INCOME VERIFICATION
Please select the number of people in your household under the Household Size column and the appropriate gross income
category from one of the (5) ve columns immediately to the right of the Household Size number.
Household Size
1 person $0 – $15,675 $15,676 – $26,125 $26,126 – $41,800 $41,801 -- $50,160 > $50,161
2 people $0 – $17,925 $17,601 – $29,875 $29,876 – $47,800 $47,801 -- $57,360 > $57,361
3 people $0 – $20,156 $20,157 – $33,594 $33,595 – $53,750 $53,751 -- $64,500 > $64,501
4 people $0 – $22,388 $22,389 – $37,313 $37,314 – $59,700 $59,701 -- $71,640 > $71,641
5 people $0 – $24,188 $24,189 – $40,313 $40,314 – $64,500 $64,501 -- $77,400 > $77,401
6 people $0 – $25,988 $25,989 – $43,313 $43,314 – $69,300 $69,301 -- $83,160 > $83,161
7 people $0 – $27,769 $27,770 – $46,281 $46,282 – $74,050 $74,051 -- $88,860 > $88,861
(Dra Income Information. Calculations are based on 2018 80% LMI data for Lehigh County.)
SEED Summer Bridge Scholarship Application 2020-02-24
