<p> Campbell County High School Local Scholarship Application</p><p>Name ______</p><p>Home or Cell phone # ______Grade Point Average ______Address______ACT or SAT Score ______Email address______Approximate class rank ______out of 308</p><p>Parent(s) Name(s) ______No. in family presently at home ______How many parents work? ______Parent(s) Employers: ______Estimated family yearly income______*Please include a copy of the page showing adjusted gross income from your family’s 2013 federal income tax form OR your 2016-17 FAFSA Student Aid Report (SAR) showing your Estimated Family Contribution (EFC). </p><p>Number of college students in household during the 2104-15 year (include yourself)______List any colleges applied to (limit 3): ______</p><p>Future Plans (Institution) Field of Study Career Plans</p><p>List extracurricular activities (school, church, community) and/or any work experience. Attach extra sheets, if necessary.</p><p>List offices held and honors received during high school. Attach extra sheets, if necessary.</p><p>List three (3) names and addresses of personal references (other than family).</p><p>On a separate sheet of paper, type an essay (500-750 words) on the following topic: “How certain are you of your future plans, and how has your K-12 education affected your desire to enter a specific career field? Please include information about coursework and/or specific teachers, community members, and others who have affected your desire to learn more about this field.” THIS APPLICATION IS DUE TO KATHERINE AYERS NO LATER THAN MARCH 18, 2016</p>