School Counselor Instructions
Please ensure the student has Encompass Community Supports listed as a recipient to receive the student’s transcripts on a semester basis.
Encompass Community Supports will notify the counselor as soon as award decisions are made. School Counselors are asked to notify Encompass Community Supports if students fall out of good standing.
Students are required to forward a copy of their annual transcripts to the Human Resource Department of Encompass Community Supports. Upon receipt of a transcript, the agency selection committee will review the student’s GPA for satisfactory performance and decide for future awards. Students failing to meet the criteria for satisfactory performance may not be eligible to receive a scholarship award for their ensuing school year.
Name*
First
Last
What kind of college program are you currently enrolled in?* Social Security Number*
Your Email*
Phone Number*
Street Address*
City*
County* Select a county... Culpeper Fauquier Madison Orange Rappahannock
You must reside in one of these five counties to apply.
State*
Zip Code*
Education High School / GED Name
City, State
Degree Received
Major Course Work
College Name
City, State
Degree Received
Major Course Work
Graduate School Name
City, State
Degree Received
Major Course Work
Other School Name
City, State
Degree Received
Major Course Work
List any special skills you possess that you would like us to consider in evaluating your qualifications for this scholarship:
What do you hope to attain after finishing your education?
Essay Please provide a one page essay in the space below or attach it at the bottom of this page under 'Other Documents'.
If you choose to upload your essay as a document below, please type "See attached" in this field to satisfy the required field setting.
How will you use your degree to positively impact your community?*
Personal Statement Please provide a one page personal statement in the space below or attach it at the bottom of this page under 'Other Documents'.
If you choose to upload your personal statement as a document below, please type "See attached" in this field to satisfy the required field setting.
Discuss your future goals. What has influenced your decision to pursue this field of study?*
Professional References List three references (E.g., teachers, school counselor, etc.) not related to you who can provide us with information concerning your qualifications for this scholarship.
Name*
Company, School or Relationship*
Phone Number*
Full Address*
Name
Company, School or Relationship
Telephone Number
Full Address
Name
Company, School or Relationship
Phone Number
Full Address
Documents
Please attach all files here.
Resume*
Please upload your resume here.
School Transcript*
Please upload your latest transcript.
Other Documents
You may upload any more files in support of your application.
Applicant's Certification and Consent I certify that the information provided on this application is true, complete, and accurate to the best of my knowledge without consequential omissions of any kind. I understand that misrepresentation of any fact may be cause for my disqualification from further consideration for the scholarship applied for or may result in revocation of any scholarship awarded. I consent to references being contacted regarding this application.
Signature Date of Signature*
MM slash DD slash YYYY
By checking 'I Agree' below, I am agreeing to the above certification and consent:* CAPTCHA
Name
This field is for validation purposes and should be left unchanged.
