Student Application Form

CCRI Alumni Association Scholarship

Instructions: Please print clearly or type. Return completed form to:

CCRI Alumni Scholarship Committee
c/o Director of Alumni Relations
Community College of Rhode Island
1762 Louisquisset Pike
Lincoln, RI 02865-4585

Applications must be hand delivered by 4 p.m. or postmarked no later than April 1.

Name________________________________________ Student I.D. #_____________________

Address_________________________________ City________________ State____ Zip_______

Telephone__________________________________ email_______________________________

1. Are you continuing your studies at CCRI? Yes__ No__

2. Do you have a G.P.A. of 2.5 or higher? Yes__ No__
If higher than 2.5, please list._____

3. Is a one-page typed essay describing your educational/career objectives and reasons why you should be selected as the CCRI Alumni Award recipient attached? Yes__ No__

4. List your college activities (include organization's name, a contact person or reference, dates of involvement, and description of duties). (Attach maximum 1/2 page.)

5. List any elected offices held in student activities (include organization's name, title of office, and years elected). (Attach maximum 1/2 page.)

6. List your volunteer/community service activities (include organization's name, contact person, dates of involvement, and description of duties). (Attach maximum 1/2 page.)

7. List any honors or awards that you have received. (Attach maximum 1/2 page.)

8. Describe any work experience during college, including the average number of hours worked per week and summarize your past work experience. (Attach maximum 1/2 page.)

I grant my permission to the Scholarship Review Committee to review my academic standing with CCRI’s Office of Admissions and Records, to review my financial need with CCRI’s Financial Aid Office, and to use my name and photo for publicity purposes.

___________________________
Student Signature/Date

Important Note: Scholarship recipient is required to write a thank you note (memo and sample thank you note) to the scholarship donor, and provide a brief biography (printable bio form) about themselves and their education/career goals and return both to: Geraldine Peixoto, CCRI Foundation, Flanagan Campus, 1762 Louisquisset Pike, Lincoln, RI 02865. Please contact the CCRI Foundation if you need assistance in completing this responsibility at 333-7150 or e-mail at foundation@ccri.edu.