The attached application should be completed by all students who are seeking a scholarship or
tuition assistance for coursework that earns Credit Hours. This includes but is not limited to:
Associate Degrees
Louisiana Transfer Associate Degrees
General Studies
Process Technology
Instrumentation Technology
Welding (if earning credit hours)
Medical Assistant (if earning credit hours)
Practical Nursing
Students attending RPCC for non-credit training such as NDT/NDE, Crane Operations,
Non-credit Welding, Scaffolding should complete the Workforce Non-Credit Tuition
Assistance Application.
Student must
1. Be enrolled at RPCC for a minimum of six credit hours in the semester for which the
scholarship is requested. Note there is no fee for class enrollment.
2. Have a current FAFSA with RPCC listed as the educational institution.
3. Submit two letters of recommendation with the application.
4. There are a number of scholarships available and some of our donors have specific criteria,
so we recommend that you complete all of the sections marked optional to ensure you are
considered for all available scholarships.
Scholarships are awarded on a semester basis; students who receive a scholarship are not
required to reapply for the subsequent semester to be eligible for consideration.
Good Luck! Student Services is available to answer application questions.
Scholarships Available:
RPCC Foundation Scholarships Rubicon REAL Scholarship
Kevin & Kelsey Memorial Scholarship Carville Energy Scholarship
East Iberville INC Scholarship Solomon-Acy Scholarship
Lambert Family/Curt Eysink Scholarship NOVA Chemicals Scholarship
Academic Programs
Scholarship Application
Fall Semester June 15
Spring Semester November 15
FSA V 2019.1
This Application is for the Fall / Spring Semester 20____
(circle one) year
Name:_______________________________________ LOLA #:__________________________
Date of Birth:_________________________________ Phone:___________________________
Current Address:_________________________________________________________________________
RPCC Student Status:
[ ] First Time Student attach High School Transcript or GED/HISET Certificate
High School Attended:___________________________________ GPA if HS Grad________
[ ] Transfer Student
Prior College:__________________________________________ GPA_________________
Dates Attended: _______________________________________
Degree(s) Earned:______________________________________
[ ] Returning RPCC Student
FAFSA Completed for Scholarship Application Period: [ ] Yes [ ] No
Program or Course of Study at RPCC:________________________________________________________
Anticipated Completion Date:__________________________________
Number of Hours Scheduled for Application Semester/Period: _____________________________
List academic achievements (use additional pages if necessary):
Academic Programs Scholarship Application
Fall Semester June 15
Spring Semester November 15
FSA V 2019.1
RPCC Foundation Universal Scholarship Application Page 2
List any extracurricular activities, club memberships, and leadership positions including high school,
college, volunteer, and community (use additional pages if necessary):
OPTIONAL SECTION you may complete only those sections that apply or none at all; failure to complete
any or all of the questions will not affect your eligibility for scholarships that are not directed to specific
Are you a Veteran? [ ] Yes [ ] No
If Yes: Branch___________________ Service Dates________________Type Discharge__________
Are you currently employed and do you plan to remain employed during the scholarship/grant
semester/period? [ ] Yes [ ] No
If Yes: hours/week?_________ Employer_____________________________________________
Did you attend the East Iberville INC Introduction to PTEC Program? [ ] Yes [ ] No
If Yes: dates:_______________ did you complete the program?____________________________
Have you or a member of your immediate family been diagnosed with cancer? [ ] Yes [ ] No
If Yes: explain how this has impacted your ability to further your education: ___________________
Do you have a disability? [ ] Yes [ ] No
If Yes: explain how this has impacted your ability to further your education:
Please list any extenuating circumstances that might affect you and/or your family’s ability to help pay
for school (use additional pages if necessary):
FSA V 2019.1
RPCC Foundation Universal Scholarship Application Page 3
I hereby certify that the information submitted in this application is true, correct, and complete to the best
of my knowledge. I authorize River Parishes Community College to release information contained in this
application (including academic records and personal biographical information) to the awarding scholarship
committee and agencies/donors providing for this scholarship. In addition, I authorize River Parishes
Community College to access my electronic academic record. I understand the names of scholarship award
recipients may be published in area newspapers, and recipients may be asked to provide a photograph. The
number of scholarship applications received could greatly exceed the amount of available funding. I
understand that filling out this form does not guarantee that I will receive a scholarship. In addition, any
debts owed to River Parishes Community College must be paid prior to the disbursement of scholarship
funds. Early withdraw from the college may result in termination of this scholarship.
Signature:________________________________ Date: _______________________
ATTACH Two Letters of Recommendation
River Parishes Community College operates in compliance with Title VI of the Civil Rights Act of 1964,
Title IX, of the 1962 Educational Amendments and Section 504 of the Rehabilitation Act of 1973. The
College does not discriminate on the basis of race, color, religion, sex, national origin, age, disability,
marital status, or veteran status. The College is also in compliance with the Family Rights and Privacy Act
of 1974 (P.L. 93-380) as amended by the (P.L. 95-568).