DATE:

STUDENT ID:

FIRST NAME:

LAST NAME:

DATE OF BIRTH:

GENDER:

FIRST GENERATION COLLEGE STUDENT (FIRST IN FAMILY TO ATTEND COLLEGE IN PURSUIT OF A BACHELORS DEGREE):

PERMANENT ADDRESS:

ADDRESS LINE 1

ADDRESS LINE 2

CITY:

STATE:

ZIP:

MOBILE PHONE:

EMAIL ADDRESS:

HIGH SCHOOL OR COLLEGE INFORMATION:

NAME OF GRADUATING HIGH SCHOOL OR COLLEGE TRANSFERRING FROM:

HIGH SCHOOL STATE:

HIGH SCHOOL CITY:

HIGH SCHOOL ZIP:

COUNTY OF GRADUATING HIGH SCHOOL OR COLLEGE TRANSFERRING FROM:

WHAT IS YOUR CURRENT GRADE LEVEL:

LIST ALL LEADERSHIP AND CO-CURRICULAR ACTIVITIES:

LIST COMMUNITY SERVICE INVOLVEMENT:

ARE YOU INVOLVED IN BAND?

ARE YOU INVOLVED IN CHOIR? 

ARE YOU A STUDENT-ATHLETE?

IF YES, WHAT SPORT?

LIST ANY AWARDS/HONORS:

WHAT IS YOUR MAJOR:

WHAT IS YOUR CURRENT GPA:

By signing this online form by selecting the "Yes" checkbox you agree to the following:

• -I understand that I must complete a Free application for Federal Student Aid (FASFA).
• -I understand as a recipient of the JCSU merit and institutional scholarships, I am strongly encouraged to complete a UNCF scholarship application and profile.
• -I hereby certify that the information in this application is, to the best of my knowledge, true and correct.

PLEASE TYPE YOUR FULL NAME:

DO YOU AGREE TO THE TERMS OF THIS APPLICATION?

SIGNATURE DATE:

*(International students with a F-1 Visas are exempt from completing a FASFA application).