Student Information

First Name *

Last Name *

Member Number

Date of Birth

Address *

City *

State *

Zip *

Cell Phone *

Email Address *

Best way to contact you *

Parent / Guardian Info

Parent/Guardian First Name *

Parent/Guardian Last Name *

Parent/Guardian Address *

Parent/Guardian City *

State *

Zip*

Parent/Guardian Home Phone *

Parent/Guardian Cell Phone *

School Information

I am a *

Graduating High School Student Returning College Undergraduate

GPA *

Activities

List your activities and club memberships in community, school, church, etc., including any offices held, and/or responsibilities: *

Awards

List any awards or special honors that you have received: *

College/University/Trade School Information

Name and scholarship mailing address* of accredited college, trade school, or university you are planning to attend, accepted to, or currently attend:

College Name *

College Address *

College State *

College Zip *

Employment History

Employer

Hours per week

Position

Responsibilities

Employer

Hours per week

Position

Responsibilities

Are you related to anyone employed by, or volunteering at Dover Federal Credit Union?*

Yes No

If yes explain

Is someone in your household employed by or volunteering at Dover Federal Credit Union?*

Yes No

Required Essay *

Applicants must submit a written essay of 750 words or less, on the following topic:
Explain the importance of savings and how it will help you in the future.

All applications and essays become property of Dover Federal Credit Union and will not be returned.

Transcript & Recommendation Letters *

Certification

Parent/Guardian Certification if applicant is under 18 years of age:

To the best of my knowledge, the information included on this application is complete and accurate. I understand my child is applying for this scholarship to help with the educational expenses of attending college. If awarded a scholarship, I agree to allow Dover Federal Credit Union to use my son's/daughter's name and photograph for marketing of this scholarship program.

Parent/Guardian Name *

Applicant Certification

I hereby acknowledge that the information submitted herewith is true and accurate. I understand I am applying for this scholarship to help with the educational expenses of attending college. If awarded a scholarship, I agree to allow Dover Federal Credit Union to use my name and photograph for marketing of this scholarship program.

Applicant Date *

All information will be treated confidentially. All applications must be submitted no later than April 30, 2024. Applications will not be accepted after the deadline date.