Mohawk Valley Community College Foundation
Scholarship Application
Please check one of the following categories:
I am a High School Senior, and have included:
1. A letter of recommendation from my High School Principal or Guidance Office
2. Copy of my High School Transcript
3. Completed Application Form
I am a current MVCC Student:
1. A letter of recommendation from an MVCC Faculty Member
2. Most recent College Transcript (request an “unofficial” transcript from Registrar’s Office)
3. Completed Application Form
Name: _____________________________________________________ Date: _____________________________________
Street: ____________________________________________________________________________________________________
City: _______________________________________________ State: ______________________ Zip: _________________
Email Address: ____________________________________________________________________________________________
Student ID Number: _________________________________ Date of Birth: ___________________________________
Home Phone Number: _______________________________ Cell Phone Number: _________________________________
Anticipated College Graduation Date from MVCC:
_________________________________________________________
Program of Study:
I am a:
Name of Scholarship: ______________________________________________________________________________________
Student’s Career Goals: ___________________________________________________________________________________
Student’s Community Service: _______________________________________________________________________________
Please forward this application, letter of recommendation and transcript to:
MVCC Foundation
Payne Hall – Room 220
1101 Sherman Drive
Utica, NY 13501
If you should have any questions, please call (315) 792-5555.
PLEASE READ AND SIGN BELOW
I understand and agree to abide by the conditions of the MVCC Foundation guidelines for any scholarship I may receive. I agree to complete the Free Application
Federal Student Aid (FAFSA) application form to apply for the PELL grant and the NYS TAP grant. I agree that the MVCC Foundation reserves the right to provide
the donor of my award and MVCC’s College and the Office of Marketing and Communication with the information about my application. I understand that any
scholarship monies awarded may be credited against my balance of any and all bills to the college. A condition of any scholarship award is contingent on my writing
thank you messages to scholarship donors and attending the annual scholarship awards recognition ceremony unless I am excused in writing by the MVCC Foundation.
SIGNATURE: __________________________________________________ DATE: _______________________________________
Have you completed the Free Application for Federal Student Aid?
Yes
No
Full-time student
Part-time student
click to sign
signature
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