Continuing Education Scholarship Application

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JOHNSON COUNTY COMMUNITY COLLEGE

CONTINUING EDUCATION SCHOLARSHIP APPLICATION

The purpose of the Continuing Education Scholarship Fund is to provide an opportunity for unemployed, underemployed, or dislocated workers to be retrained and reemployed following completion of a Johnson County Community College (JCCC) Continuing Education (CE) training program. Pl

Please visit www.jccc.edu/CEScholarship to review eligibility criteria and for information regarding the application process prior to completing the form.

First Name:

Last Name:

JCCC ID#:

Address:

City:

State:

Zip:

Contact Number:

Email:

Date of Birth:

Gender:

Semester for which you are applying for scholarship:

Fall

Spring

Summer

Year

Class/ Program applying for:

Course Code(s)

Class Start Date:

Class End Date:

Please complete the following questions:

Please explain in detail your employment goals including why you have chosen this career path. Then provide a summary of why you are requesting financial assistance and an explanation of how this program/course will help you reach your employment and career goals.

After completing this course of study do you have further education to reach your employment goals?

How much funding are you applying for?

Are you currently receiving any other financial assistance to attend school (past, present or future employer, or scholarship, grants federal assistance)? If yes please list the amount of money you are receiving and from what source:

Given your other responsibilities, how much time do you have to commit on a weekly basis to achieve your goal?

If awarded a JCCC Continuing Education scholarship, I agree to write a note of appreciation to the individual or organization responsible for funding my scholarship.

If awarded, I agree to share with JCCC when I gain employment and the company name.

This checkbox will serve as your electronic signature.

This application is good one year from the date of completion.

*For your protection, as the FAFSA form contains personally identifiable financial information, we do not recommend emailing the form as email is not inherently secure.

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