<p> Huron County Community Foundation Payne, Nickles & Company Scholarship Application</p><p>ACCOUNTING SCHOLARSHIP</p><p>Payne, Nickles & Company, CPAs, through the Huron County Community Foundation (an affiliate of the Community Foundation of Lorain County), is proud to announce it is again offering up to two (2) $2,000 scholarships for the 2018-2019 academic year. The scholarship is open to second, third, fourth and fifth year students with accounting majors, and is intended to assist the student in meeting the 150-hour requirement to take the CPA exam.</p><p>Eligibility Criteria:</p><p> Erie/Huron, or contiguous counties, Ohio resident  Minimum 2.8 grade point average  Completion of the Free Application for Federal Student Aid (FAFSA)</p><p>The application must be received by 5 p.m. Friday, May 4, 2018. Our scholarship is based on field of study, merit, financial need and community involvement. The decision is final and will be announced in late June. The scholarship will be paid to the school (not to an individual or bookstore) in one installment. </p><p>The Firm’s offices are located at 422 West Market Street in Sandusky and 257 Benedict Avenue, Bldg. D in Norwalk. Scholarship applications can be picked up at either location, or printed from the Payne, Nickles & Company web site at www.pncpa.biz or the Huron County Community Foundation website at www.peoplewhocare.org. All completed applications should be submitted to the Huron County Community Foundation, 12 Benedict Ave., Norwalk, Ohio 44857. Huron County Community Foundation Payne, Nickles & Company Scholarship Application</p><p>HURON COUNTY COMMUNITY FOUNDATION APPLICATION FOR PAYNE, NICKLES & COMPANY ACCOUNTING SCHOLARSHIP</p><p>(Please type or print)</p><p>PERSONAL</p><p>Name ______SSN ______Age ______</p><p>Address ______</p><p>City, State & Zip ______Telephone # ______</p><p>Email ______</p><p>Length of residency in Erie, Huron or contiguous county______</p><p>Marital Status ___ # of children_____</p><p>Name of Parents/Guardians/Spouse ______(First and Last Names)</p><p>Father’s Occupation ______Place of employment ______</p><p>Mother’s Occupation ______Place of employment ______</p><p>Spouse’s Occupation ______Place of employment ______</p><p>Siblings in College/Graduate School</p><p>Name ______College ______Year ____</p><p>Name ______College ______Year ____</p><p>Name ______College ______Year ____</p><p>SCHOLASTIC</p><p>The educational institution you are currently attending:</p><p>College ______Graduation Date ______</p><p>GPA: Overall ______Major(s)______Huron County Community Foundation Payne, Nickles & Company Scholarship Application</p><p>Scholarship Application of: ______Page 2</p><p>Other scholarships or financial assistance you have applied for or received:</p><p>Grantor ______$ applied for ______Received ______</p><p>Grantor ______$ applied for ______Received ______</p><p>Grantor ______$ applied for ______Received ______</p><p>Work experience (organization, dates of employment, supervisor and phone #)</p><p>______</p><p>______</p><p>______</p><p>REQUIRED ATTACHMENTS</p><p>1. Official, sealed transcript of your college or post-high school/college courses and grades. 2. Copy of your Free Application for Federal Student Aid (FAFSA) or your Student Aid Report (SAR). 3. A list of your extracurricular activities in chronological order. 4. A personal statement in two (2) pages or less preferably typed. Your statement should include information that would help us in knowing you and in determining your eligibility or need. Include how you are financing your education, previous work experience, reasons for choosing your professional goals and also your current experiences and long range plans after graduation. 5. Any additional information you wish to send (e.g., letters of recommendation).</p><p>I hereby give the Huron County Community Foundation permission to contact any of my teachers, supervisors, professional and educational institutions I have attended/applied to/have been accepted for admission/membership, for further information about my attendance, performance, financial circumstances and references.</p><p>Applicant’s Signature ______Date ______Huron County Community Foundation Payne, Nickles & Company Scholarship Application</p><p>Huron County Community Foundation Privacy Policy</p><p>Issued pursuant to Title V of the Gramm-Leach-Bliley Act to provide information on our policies regarding privacy of applicant information. The Huron County Community Foundation does not disclose nonpublic personal information received from applicants unless authorized and will continue that tradition. We have and will continue to always protect your right to privacy.</p><p>Types of Nonpublic Personal Information We Collect</p><p>We collect nonpublic personal information about you that is provided to us by you or obtained by us with your authorization.</p><p>Parties to Whom We Disclose Information</p><p>For current and former applicants, we do not disclose any nonpublic personal information obtained in the course of our business to anyone, except as authorized by you or as required or permitted by law. Permitted disclosures include, for instance, providing information to our employees, and in limited situations, to unrelated third parties, such as financial institutions, who need to know that information to assist us in providing services to you. In all such situations, we always stress the confidential nature of the information being shared.</p><p>Protecting the Confidentiality and Security of Current and Former Applicants’ Information</p><p>We retain financial records so that we are better able to assist you with your needs and, in some cases, to comply with requirements. In order to guard your nonpublic personal information, we maintain physical, electronic, and procedural safeguards.</p><p>********************</p><p>Please call if you have any questions, because your privacy is of the utmost importance to us.</p>