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Please fill all information as requested and submit.

Application NOT submitted. Please scroll down and fix errors.
First Name:
Please enter your first name.
   
Middle Name:
Please enter your middle name.
   
Last Name:
Please enter your last name.
   
NRCC Student I.D.:
Please enter a student id that is numeric only.
Your student id must be 7 digits long.
If you do not have your student I.D. number yet, leave blank.
Address Street:
Please enter your address.
   
City:
Please enter your city.
   
State:
Please choose your state.
   
Zip:
Please enter your zip code.
   
City/County of Residence: Floyd Giles Montgomery Pulaski Radford Other:
Please give your residence.
You selected other, please type in box your residence.
You selected other, please type in box your residence using 50 characters or less.
Date of Birth: (MM/DD/YYYY)
Please enter your date of birth using MM/DD/YYYY
   
Telephone:
(preferably cell)
( ) -
Please enter your telephone number.
   
E-mail:
Please enter your e-mail address.
   
 
Citizenship: U.S. Citizen Yes No
Please check your citizen status.

If no, are you a permanent resident? Yes No
Visa Type  
NOTE: International students in the U.S. on a student visa are not eligible for this program.
         
High School you are attending or attended:        
Please select your high school state.
High School options will appear here after state is selected.
Please select your high school.
Please check your high school dates for accuracy.
       
Dates Attended From: (MM/DD/YYYY)
Please select your high school start date and use MM/DD/YYYY
 
Dates Attended To: (MM/DD/YYYY)
Please select your high school end date and use MM/DD/YYYY.
 
   (a) Graduated: Yes No Equivalent
Please enter your graduation details.
You selected will graduate, please choose a date and use MM/DD/YYYY
    Will Graduate in: (MM/DD/YYYY)
 
Applicant must submit a copy of high school transcript and if applicable, a copy of all college transcripts,
(including NRCC transcripts) to the NRCC Financial Aid Office. Your transcripts must be received by the application deadline.
               
College(s) Attended: (If you have not attended college yet, please leave blank.)    
College options will appear here after state is selected.
 
College options will appear here after state is selected.
 
Are you currently attending NRCC? Yes No
Are you currently attending NRCC?
(If "Yes") How many credit hours this term completed
You selected you currently attend. Please input hours/term, hours/completed, and first enroll information.
(a.) (If "Yes") When did you first enroll?
(b.) (If "No") When do you plan to enroll at NRCC? Semester Year
You selected no. When will you enroll?
(c.) What is (or will be) your major or plan of study?
What is your plan of study?
 
VERY IMPORTANT: This question must be answered to be awarded a scholarship. If undecided, list a tentative area of study.  
(d.) What is your proposed future occupation, if known?  
Do you plan to earn a two-year degree at NRCC? Yes No
Please select yes or no.
Do you have any immediate family members who have graduated from NRCC? Yes No    
If yes, list name, relationship, and year graduated:
Extracurricular Activities: High School and/or College (list school, activity, year, offices held):    
     
               
16. Honors and Awards: High School and/or College        
Honor: School: Year:      
Honor: School: Year:      
Honor: School: Year:      
Honor: School: Year:      
               
17. Current Employer full time part time hours per week  
Employer Address: hourly wage:
Employer City: Employer State: Employer Zip:
       
18. Financial Information:      
NOTE: If financial information is not provided, application will not be considered.
Are you a self-supporting or dependent student?
You must choose your status and fill related information.
You must fill all related information.
Financial options will appear here after type is selected above.
 
 

Additional Financial Information: Please describe any special circumstances regarding your financial situation that you would like the selection committee to consider.



 
19. References of two people NOT related to you. (It is preferred that at least one letter be from an educator or former employer.)
(a.) Name: Connection to you:
Address: City:
State: Zip:
You must enter all data for both references.
 
(b.) Name: Connection to you:  
Address: City:
State: Zip:
 
NOTE:
You must request the two persons listed above to write a letter of reference in your behalf and send their letters before application deadline, to:

Educational Foundation Office, New River Community College, 5251 College Drive, Dublin, VA 24084.
(540) 674-3600 ext. 4216

Letters of reference must be received by the application deadline.
Applications without two letters or without other required information as previously noted, including financial information (in question 18) and transcripts, will not be considered.
       
NOTE: Answers to questions 20 - 35 will not be used in the selection process. The information will be used to match those who receive scholarship awards with specific criteria after all recipients have been chosen. For that reason this section must be completed by all applicants for the application to be complete.
 
20. Are you an employee of or related to an employee of any of the New River Valley companies listed below?
(If yes, check the box and write the employee’s name and your relationship.)
There were issues with your choices. Please make sure if you have a company checked, and you also filled information in the text box.
Max characters allowed for relatives is 200.
Please use company checkboxes.
Alliant Tech Systems / BAE   
Carilion Saint Albans Hospital   
Celanese Acetate   
Huff Petroleum Co., Inc.   
Kollmorgen   
LewisGale Hospital at Pulaski   
MOOG Components Group   
National Bank of Blacksburg   
VOLVO Trucks NRV Plant (Immediate Family Only)   
Wolverine Advanced Material Division   
 
22. Are you a descendent of a Dublin High School graduate? Yes No
               
23. Do you plan to pursue a degree in at music at a four year university? Yes No
               
24. Are you an upcoming 2015 Giles graduate applying for Access to Community College Education (ACCE)? Yes No
               
25. Do you or your family operate a farm in the NRCC service area? Yes No
               
26. Are you a member of the CELCO Federal Credit Union? Yes No    
               
27. Are you or a family member a barber or cosmetologist? Yes No
     
28. Are you or your immediate family a member of the United Auto Workers Local 2069? Yes No
     
29. Are you a former student of Pulaski County Teacher Carol Hancock? Yes No
               
30. Have you been accepted into a nursing program at NRCC? Yes No
(If yes, check the corresponding box below.)    
Associate Degree Nursing program        
Practical Nursing Program        
               
31. Are you enrolled in the NRCC Center for the Deaf and Hard of Hearing? Yes No
               
32. Do you plan to pursue a career in any of the following fields? (Check any that apply)
Please use the careers checkboxes.
Business or a related field (accounting, marketing, management)
Communications (electronic or print media, film, graphic design)
Computer science or information technology
Electricity or electronics
Elementary education
English
Law enforcement
Machine shop technology or machine technology
Science education
Welding
               
33. Do you intend to transfer after graduating from NRCC? Yes No
               
34. Are you a veteran of the U.S. Armed Forces Yes No
If yes, list branch and dates of service:
               
35. Are you or a family member associated with the construction industry? Yes No
               
36. PERSONAL SUMMARY
Please use the following space to tell us about yourself. For example, you might address why you chose NRCC, your educational and career goals and how the scholarship would help you achieve your goals. Include any information about your background, achievements, and needs that you feel will assist the selection committee in its deliberations. The length of your summary should be approximately 250-400 words. Be sure to proofread for correct grammar, usage and spelling.
Please include your summary.
PERSONAL SUMMARY

By clicking the "Submit Application" button below, you agree to the following:

I hereby certify that to the best of my knowledge, the information submitted here is complete and correct, and I fully understand
my responsibility in meeting and maintaining the conditions established for the scholarship for which I am applying.

I understand that (a) these awards are for students who plan to attend the college for both the Fall 2015 and Spring 2016
semesters; and (b) that unless otherwise noted, these awards require that students be enrolled for at least nine (9) credit hours
per semester.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Your application was successfully submitted.
Please print for your records.



Have you?



  Submitted copies of all high school and college transcripts to the NRCC Educational Foundation Office? The applicant is responsible for obtaining all transcripts, including NRCC TRANSCRIPTS. (When requesting NRCC transcripts, indicate to Admissions Office that the transcript is for NRCC and that you are requesting an unofficial copy. If you graduated from high school over 10 years ago, high school transcripts are not required.)

By the application deadline, official transcripts must mailed to the address below or hand-delivered to the foundation office in
Godbey Hall, office 07.
Mail:
NRCC Educational Foundation
5251 College Drive
Dublin, VA 24084
   
  Asked those persons you listed as references to send their letters of reference to the NRCC Educational Foundation Office?
  Email: bjones@nr.edu (MUST BE E-MAILED BY PERSON WRITING LETTER OF RECOMMENDATION. THE LETTER WILL NOT BE ACCEPTED VIA E-MAIL FROM APPLICANT.)
Fax: 540-674-3668
Mail:
NRCC Educational Foundation
5251 College Drive
Dublin, VA 24084
   
  Checked with Educational Foundation Office to ensure that these letters have been received?

NOTE: It is your responsibility to make sure your application file is complete. Please contact the Educational Foundation Office BEFORE February 15th to check the status of your file.