Scholarship Application

I am currently a: (select one)
Select your school:*
If not listed above, provide your current school:
City where your school is located:
State where your school is located:

Please Note: Applications cannot be saved and completed at a later time. An incomplete application will not be reviewed. 


* Denotes required field.
SECTION ONE
First Name:*
Middle Initial:
Last Name:*
Suffix:
Mailing Address:*
City:*
State:*
Zip Code:*
Telephone:*
Date of Birth (mm/dd/yyyy):*
Your Charter Oak FCU Member Number:
Email Address:*
How did you hear about our scholarship program? (choose one):*
If other, how did you hear?
Class Rank:
Grade Point Average:
 
If you are under 18, do your parents bank with Charter Oak Federal Credit Union? (If yes, please provide their name(s) and member number(s):
Parent/Guardian Name:*
Parent/Guardian Member Number:
Parent/Guardian Name:
Parent/Guardian Member Number:

Do you work at Charter Oak Federal Credit Union?
Do any of your relatives work at Charter Oak Federal Credit Union?: If yes, please list them below.
Name:
Name:
Name:

What college will you be attending this Fall?:
City:
State:
College Student - check box if:
  • I currently attend the college listed above
If undecided, what colleges have you applied to? (Please list them below.)
College:
City:
State:
College:
City:
State:
College:
City:
State:
College:
City:
State:
I'm interested in the following career or industry:

List all extracurricular activities below: sports, community involvement/volunteerism, etc.
Activity #1:
Hours per week:
Briefly tell us about this activity.
Activity #2:
Hours per week:
Briefly tell us about this activity.
Activity #3:
Hours per week:
Briefly tell us about this activity.
Activity #4:
Hours per week:
Briefly tell us about this activity.
Activity #5:
Hours per week:
Briefly tell us about this activity.

In 3 sentences or less, tell us more about what fuels your desire to be involved in the activities listed above.

SECTION TWO

ONLY CURRENT HIGH SCHOOL STUDENTS MUST COMPLETE THIS SECTION. 
To assist the Scholarship Committee with its determinations, the following information from your parent(s)/guardian(s) is necessary. In addition, finalists may be required to submit a copy of their parent(s)/guardian(s) 2018 1040 tax return. All information furnished on the statement will be treated as confidential information.
Parent/Guardian Occupation:
Parent/Guardian Occupation:
Gross Annual Family Income:*
 
Total number of persons dependent on the above income (including yourself):*
 
Are any of these individuals attending college?
 
If so, where (college name)?
 
Do they live at school?
 
 

SECTION THREE
EMPLOYMENT
Current Employer (include city and state):
Job Title:
Date of Hire:
Gross Annual Income:
Can anyone claim you as a dependent?
Total number of persons dependent on listed income:
Are any of these individuals attending college?
If yes, do they live at:
If yes, name of college:
City:
State:
SECTION FOUR
ESSAY
You were just gifted $50,000, BUT you can’t spend a dime on yourself. In 500 words or less, tell us how you would spend the money. 
Please enter your essay below:

SECTION FIVE
OPTIONAL
Please give us any additional information about your financial needs that we should consider when reviewing your application:
ReCaptcha Field

Thank you! Your information has been submitted and is currently being processed.

Thank you,

Charter Oak Federal Credit Union

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