Instructions: Complete this form. Fill in all blanks. Incomplete forms are not eligible for consideration. Follow instructions at the end of this document to submit your application.

Name

First Name

Last Name

Phone

Phone: Cell and Home numbers

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Current High School or College

School you plan to attend full-time in the Fall semester of 2025 and Winter semester of 2026:

Muskegon Community College

Muskegon Baker College

Mark your Fall 2025 Status:

Overall GPA:

How did you hear about this scholarship?

Who or what has had the greatest influence on your desire to pursue a college education?

How will you pay for your college expenses and what are you doing now to prepare?

What will be your major field of study?

List offices you have held, honors and recognitions you have received.

List school activities, community organizations and/or volunteer work in which you participated.

Why should you be considered for the WDCC scholarship?

Date

YYYY