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Application for The Noel Lee, Jr. Memorial Scholarship

Sponsored by The Volunteer Action Committee Of Edgecombe-Martin County EMC

Applicant's Name*:  
Address*:  
City*:   State*:   Zip*:  
Phone Number*:  
Date of Birth*:  
Social Security Number (Last 4 digits)*:  
Sex:
EMC-EMC Account Number*:  

Vocational/Technical/Community College or other institution to which you have been accepted or planning to enroll:
Course of study you plan to pursue:
Place of employment:
Occupation:
Total Household Income $:
(from Federal Income Tax form 1040, 1040A or 1040EZ)

Other sources and amounts of income if any:
(include social security, child support, etc.)

Asset Information
Current Value Balance Owed
Cash, Savings, Checking
Home (renters enter N/A)
Other Real Estate/Investments
Business and/or Farm Assets

Community, civic, and church activities/involvement:
Hobbies, interests and talents:
Essay:


Qualifications:
In order for an applicant to be eligible he/she must be a member of EdgecombeMartin County EMC or live in a home served by the cooperative. Awards are made on the basis of financial needs, family circumstances and plans for the future. This scholarship is intended for the use of a student who plans to complete a one or twoyear vocational/technical/community college program of study. The technical school or community college must be accredited in North Carolina.

Funds Available:
The Noel Lee, Jr. Memorial Scholarship is awarded annually. The scholarship check is sent directly to the learning institution and may be used for tuition, books and laboratory fees. In the event that the recipient leaves the institution for any reason and funds of the scholarship remain, the institution is to return the balance to EdgecombeMartin County EMC. Should the recipient leave an institution to continue education in another institution, any balance of the scholarship will be available for the institution of his/her choice, subject to the same terms and condition of the original scholarship. The recipient may accept other scholarships, but in the event the recipient receives financial assistance from other sources, which would constitute a full scholarship, he/she shall notify EdgecombeMartin County EMC and relinquish the rights to the Noel Lee, Jr. Memorial Scholarship. The monies shall then be awarded to the runnerup, provided that person continues to meet requirements.

Special Fields of Interest and Information:
The scholarship is not available for students who plan to complete a four year undergraduate course leading to a bachelor’s degree. The judging of applicants and selection of the winner(s) is the responsibility of the Volunteer Action Committee. All applicants for this scholarship shall be considered on the established criteria without regard to race, age, color, religion, sex or national origin. Awards will be made on the basis of the applicant’s financial need, family circumstances and plans for the future. The deadline for all applications to be submitted is July 22, 2011.



 
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