WTAGC Scholarship Application

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PERSONAL

Expected Texas Phone

Name

First

Middle

Last

Home Address:

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Home:

Cell:

Email Address:

Social Security #

Are You a U.S. Citizen?

If not a U.S. Citizen, what type of visa do you hold?

(Upload copy of proof at the end of form)

Marital Status:

Single
Married

Spouses Name:

Number of Dependents:

Parent or Legal Guardian's Name:

Relationship:

Address if different than home address above:

Address Line 1

Address Line 2

City

State

Zip Code

College (if applicable)

College Address:

Address Line 1

Address Line 2

City

State

Zip Code

At which address can you be contacted in July?

Home
College

Relationship and Identity of West Texas AGC Member (if applicable)

Name:

Relationship:

Company Name of West Texas AGC Member

SCHOLASTIC

Provide names, city, and state of high schools, colleges, and/or universities you have attended or are currently attending, most recent first. Be sure to indicate month and year of completion or anticipated graduation.

Name of School / Location (City/State) / Major / Month & Year to Graduate

Activity after High School

Provide a chronological history of your activities if NOT continuously enrolled in school since high school graduation. History should begin immediately after high school graduation until the present time. Include specific month, year, and type of activity.

Provide High School Counselor Name and Email

University of Enrollment / Address / Telephone

If you are currently enrolled in a 4-year or 5-year university from which you intend to earn a degree in a construction related degree or construction/civil engineering, please provide the institution's name, mailing address, and a telephone number of the department. Please mark "Accepted" if you have been accepted to this school and list your anticipated graduation (month/year).

College or University Applying To:

If you are not currently enrolled at college or university, or are planning to transfer to another school, list college or university, city and state. Please mark "Accepted" if you have been accepted to this school and list your anticipated graduation (month/year).

College or University Applying To:

Identify the program of study you are entering and expect to earn your degree:

Specify Grade Point Average (Cumulative GPA on a 4.0 scale)

(Upload official or unofficial grade transcript form the school you are presently attending, as well as transcripts from previously attended schools at the end of form)

Extracurricular School Activities

List any activities you have participated in while attending school. Indicated elected offices held, if any. List any student activities (student government, National Honor Society, school clubs, UIL academic events, sorority/fraternity, etc.), community activities (Boy/Girl Scouts, Church, etc.), and athletics.

List notable honors, awards, etc. you have received while as a Junior or Senior in High School or in college:

Sources for Funding your College Expenses

Amount of Funding Expected from Work

% of Total

Amount of Funding Expected from Family Members

% of Total

Amount of Funding Expected from Loans

% of Total

Amount of Funding Expected from Scholarships

% of Total

Amount of Funding Expected from other Sources

% of Total

Total From All Sources:

% =

100%

Estimated Annual College Expenses:

(Tuition, Room, Board & Books)

Upload your files here:

Click or drag files to this area to upload. You can upload up to 12 files.

(*Copy of ACT, SAT, or TSI A2 Scores, *Copy of High School or College Transcript of Academic Record, * Minimum of 2 Letters of Recommendation from Teachers or Faculty Members, *Essay stating why Applicant is pursuing a Construction Education/Career (2 Pages Maximum), *Proof of Visa for non U.S. Citizens)

WTAGC Scholarship Application

SCHOLARSHIP APPLICATION

PERSONAL

Phone

Sources for Funding your College Expenses