BOARD OF TRUSTEES SCHOLARSHIP APPLICATION

BOARD OF TRUSTEES SCHOLARSHIP APPLICATION
Name of Student Recommended by Counselor:
(First, Middle, Last)
Date of Birth

MonthDayYear
Date
SSN or TVIN
(Street or P.O. Box, City, State, Zip)
High School Attended
(Name of HS, City, State, Zip)
Date of Graduation

MonthDayYear
Date
DOB or TVIN.
State law requires that each student identify any relation to a current member of the board of trustees. A student who is related to a current member of the governing board of that institution is prohibited from receiving scholarships unless the scholarship is awarded exclusively based on academic merit or is an athletic scholarship. It is a Class B misdemeanor to file a false statement. Please review a list of current Trinity Valley Community College Board of Trustees members at www.tvcc.edu/board-of-trustees and then select the most appropriate answer below indicating your relation to any of the members of the board of trustees.
or niece (daughter of brother or sister)
or niece (daughter of brother or sister)
grandparent’s spouse; or grandchild’s spouse
If yes, explain
Signature of Counselor
Should be Empty: