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This document is a scholarship application for Butler Community College. It requests information such as the applicant's name, contact details, high school and college history, extracurricular activities, and demographic information. The application notes that students must reapply annually, lists the preferred application date of March 1st, and provides contact information for different types of scholarships including academic, athletic, and nursing. It indicates that applicants must maintain a 3.0 GPA and 12 credit hours per semester to keep their scholarship.
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- 1. Pure Learning Power Butler Student 14ASA ID Number: Example: @00111111 or Z00011111 or Social Security Number if Butler Student ID is Not Established 2013-2014 Scholarship Application Complete and return this form to the Office of Student Financial Aid. Your application will be reviewed by the scholarship committee. You must reapply each academic year for scholarships. Preferred Application Date – March 1 Applications received after March 1st will be reviewed • Contact the Athletic office for athletic scholarship requirements. • Contact the Activity sponsor for activity scholarship requirements. (i.e. music, journalism, theatre, etc.) • Contact the Office of Student Financial Aid for academic scholarships (i.e. Academic Excellence, Deans, Presidential, Salutatorian, Valedictorian) and Foundation scholarship information. • Contact the Nursing Department for nursing scholarship requirements. • You must fill out a Free Application for Federal Student Aid (FAFSA) to receive federal financial aid and state scholarships. Please Print or Type 1. Legal Name Last First Middle (other names used) 2. Birth Date 3. Date Received or Will Receive High School Diploma or GED (MM/YYYY) 4. Local Telephone Permanent Phone (include area code) 5. Permanent Address City State Zip County and State of Legal Residence Country of Legal Residence 6. List All High Schools Attended City State Dates Attended Graduated Yes No Yes No 7. List All Colleges Attended City State Dates Attended Yes No Yes No 8. Check this box if you have not attended college, or only attended Butler since earning your High School Diploma or GED 9. List organizations you have participated in and any special honors you received in high school, college or through community involvement. Feel free to attach an additional sheet if needed. Over
- 2. Butler Student 14ASA ID Number: Student Last Name First Name M.I. Example: @00111111 or Z00011111 or Social Security Number if Butler Student ID is Not Established Please check all boxes that apply to you: Butler Alumni Student Ambassador Dependent of a Veteran Butler Operational Staff Home School Camp Butler 2000 Graduate Member of Butler Campus Crusade Dependent of a Butler Alumni (Parent/Grandparents) Member of Butler Student Senate Dependent of a Butler Operational Staff Non-Traditional Student I will work at least 8 hours per week off-campus while attending Butler I am a ‘Single Parent’ with dependents receiving more than half of their support from me The following information will be shared with the Butler Community College Foundation and includes: the data contained on this scholarship application, academic records, your financial aid expected family contribution, and other award information. By signing this scholarship application, I acknowledge and release all information associated with my application to the Butler Community College Foundation. I understand that I must be enrolled in a minimum of 12 credit hours each semester (exception: students admitted to the Nursing program and part-time Butler Foundation scholarship recipients). I understand my scholarship may be revoked if I do not maintain at least a 3.0 GPA and complete 12 credit hours each semester. Submitting a scholarship application does not guarantee a scholarship award. Required Applicant Signature: Date:  Any athlete receiving an athletic scholarship: If receiving an additional academic scholarship per Kansas Jayhawk conference rules will be required to have a final high school overall GPA of 3.5 or greater to receive an award and maintain at least a 3.5 overall GPA to have a scholarship renewed each semester. Entering First Year Student: GPA for a graduating high school senior must include at least 6 semesters, be verified by a high school official signature, and include the school seal. ** Overall GPA (Unweighted) A = 4.00 Number of Semesters Included in GPA Rank in Graduating Class Number in Class ACT Composite Test Score Name of High School Accredited by (please list organization) High School Address City, State, Zip High School Telephone Number Verification by: Signature of counselor, registrar, or other school official Date Printed Name and Title: ** If the information provided above changes, please contact our office before the first day of classes. Changes in your ACT or High School GPA prior to your first semester of your freshman year could increase your eligibility to receive a scholarship. PHONE: 316.218.6260 FAX: 316.733.6240 e-mail: finaidmail@butlercc.edu Return This Form To: Office of Student Financial Aid Butler Community College 1810 North Andover Road Andover, KS 67002 High School Seal (The GPA cannot be rounded up and must be accurate to 4 decimal places.) Certain scholarships are based on financial need. In order to determine eligibility for these scholarships, as well as federal aid you must complete the Free Application for Federal Student Aid which can be found at www.fafsa.gov.