8.20.19

Mississippi Works Career- Tech Scholars Program Application

Personal Information Social Security Number: _____-_____-_____ Date of Birth: _____ /_____ /_____ College ID Number:______Name:______(______) First Middle Last (Maiden) Campus you plan to attend: Coahoma Community College Meridian Community College Co-Lin Community College MS Delta Community College East Central Community College MS Gulf Coast Community College East MS Community College Northeast MS Community College Northwest MS Community College Holmes Community College Pearl River Community College Itawamba Community College Southwest MS Community College Jones County Junior College

Have you previously participated in the Works CTE Scholars Program? Yes No What semester do you plan to attend: Fall Spring Summer Academic Year? ______Pathway/Program of Study: ______MS Resident? Yes No E-mail: ______Cell Phone Number: ______- ______- ______Physical Address: ______Street City State Zip Country Mailing Address: ______if different from physical - Street or P.O. Box City State Zip Country Gender: Male Female U.S. Citizen? Yes No Race/Ethnicity: (You may choose more than one) ___White ___ Black or African American ___ Asian ___ American Indian or Alaska Native ___ Hispanic/Latino ____Native Hawaiian or Other Pacific Islander ____Prefer not to disclose Date FASFA Submitted______Date Mississippi Financial Aid Application Submitted______Students must submit applications for the program by September 1 for the fall semester; February 1 for the spring semester; and June 1 for the summer semester, if applicable. Mississippi Works Career-Tech Scholars Program Certification I understand the Mississippi Works Career-Tech Scholars Program is a state assisted tuition scholarship program that only covers tuition costs and is available to qualifying applicants only if the tuition is not covered by other federal (Pell) and state grants. Furthermore, I am responsible for fees or any other costs associated with the career-tech program in which I enroll. I agree to adhere to all rules and regulations of the Mississippi Works Career-Tech Scholars Program. Any balance after the Mississippi Works Career-Tech Scholars Program has been applied shall be the responsibility of the student. Student’s Signature______Date______

Application to be returned to your campus Career Technical Office.

Mississippi Works Career- Tech Scholars Program Application

In order to participate in the Mississippi Works Career-Tech Scholars Program (MWCTS), the following requirements must be met: 1. Be a legal resident of Mississippi who is admitted to both a public community college and an eligible career-tech program. 2. Be a full time student according to the chosen community college’s policy and successfully complete an established number of hours in an eligible career-tech program. If a student fails to successfully complete the established number of hours in an eligible career-tech program to maintain eligibility, the student may be classified as probationary for one semester in order to continue participating in the MS Works CTE Scholars Program. 3. The MWCTS Program is available to previous postsecondary completers that earned a certificate or degree, pending compliance of admission criteria. Once admitted to the Mississippi Works Career-Tech Scholars Program, participants must meet the following requirements: 1. Be a full time student according to the community college’s policy and maintain full time enrollment. 2. Maintain a minimum 2.0 GPA each semester and successfully complete courses as prescribed by the program curriculum. 3. Participate in available work-based learning opportunities in the selected field of study. Process for applying for the Mississippi Works Career-Tech Scholars Program: 1. Apply and be accepted to the community college of their choice. 2. Be admitted to an eligible career-tech program. 3. Submit a Free Application for Federal Student Aid (FAFSA®) for federal financial aid at https://fafsa.gov. 4. Submit an application for state financial aid at www.msfinancialaid.org. 5. Submit an application for the Mississippi Works Career-Tech Scholars Program to the office specified by your college. OFFICE USE ONLY _____ Student has applied for federal student aid. _____ Student has applied for Mississippi state aid.

Application to be returned to your campus Career Technical Office.