Foundation Scholarship Application – Three Rivers Community College Foundation

APPLICANT INFORMATION

Scholarships are a way for students to help pay for college. Students may earn a scholarship based on financial need, academic standing, service to the College and community, or a combination of these factors. Scholarships may not be used to purchase non-educational related items such as rent, gas, food, household items, childcare, etc. Please contact the Office of Student Development in Room C131A, rebecca.kitchell@ctstate.edu or call 860-215-9240 for more information and assistance.

First Name*

Last Name*

Banner ID*

Make sure to type the number in the format shown: @00000001.

Phone*

TRCC Email*

Address*

Street Address City State ZIP Code

Sex

Female
Male
Choose not to answer

Ethnicity/Race*

Graduation*

Are you graduating this May?

Yes
No

Is your HOME campus Three Rivers?*

To be eligible for scholarship support, your home campus must be Three Rivers.

Yes
No

ShopRite*

Are you an employee, child or grandchild of ShopRite stores?

Yes
No

Alumni

Is your parent, grandparent, or legal guardian a graduate of one of the following

Thames Valley State Technical Institute
Mohegan Community College
Three Rivers Community College

Personal Statement*

How will a scholarship help you achieve your educational, career and/or personal goals. Please note: this answer may be shared with donors of the Foundation.

Tuition, Books, Technology and Other Needs*

Use this space to explain why you are seeking scholarship support and how much funding you anticipate needing. If you do not provide specific details, we may not be able to process your request. Please note: this answer may be shared with donors of the Foundation.

Student Life

If applicable, list clubs, student life, extracurricular activities and volunteer work you participate in. Please note: this answer may be shared with donors of the Foundation.

Degree Works*

Accepted file types: screenshot, doc, docx, pdf, Max. file size: 50 MB.

Submit a copy of your Degree Works that can be found by going to myctstate, student self service, access degree works, program audit, click the print button and save as a pdf to upload.

Student Bill*

Accepted file types: doc, docx, pdf, screenshot, Max. file size: 50 MB.

Upload a copy of your student bill from the prior semester, not the upcoming one. To find this, log in to myctstate, student accounts and billing, my account, under my account, click on account activity, select most recent semester bill, save as PDF. Please note: Applications will not be processed without the correct bill from the prior semester.

Privacy Notice and Consent*

CT State Three Rivers is committed to your overall success including securing your personal information and maintaining your privacy when we collect personal information. If you apply for a scholarship, the Three Rivers Advancement Office (“We”) will only use your application information for the purpose of determining scholarship eligibility and administering scholarship benefits if awarded. If you are selected as a scholarship recipient, We may disclose your name, GPA and information from your personal statement with Three Rivers Foundation donors (“Donors”) for the purpose of relaying the value their contributions to the Three Rivers community. We may also include your name, photograph, if applicable, and personal statement in the annual report for the purpose of informing the broader community about your success. To administer scholarships that include payment for books and other educational expenses, we will provide your name, Banner ID, e-mail address and phone number to the Follett Bookstore so that scholarship benefits can be accurately distributed. By submitting this scholarship application, you are providing official consent for your personal information provided as a part of the application to be used for the purposes described in the privacy notification.

Acknowledgment*

I understand that funding associated with my financial aid package will be used before I receive additional funding. Balances will not be paid out and do not carry over to the next semester.

Phone

This field is for validation purposes and should be left unchanged.

Scholarships

APPLICANT INFORMATION

Questions?