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Bergen County Charity Scholarship Application


- Please complete all fields unless otherwise noted -

Student Information

First Name: Last Name:
Email Address: Birthdate:
Home Phone: Cell Phone:

Home Street Address Home City
Home State
Home Zip

High School Name: GPA (As of Jan 1, 2018)

Sibling Information (If Applicable)
First NameLast NameAgeCurrent School


Selection Criteria
In paragraph form, tell us how you meet our stated criteria and why you would be a worthy recipient of this scholarship. (250 words or less)

Word Count: 0


Financial Need
In paragraph form, tell us about your financial need



Please provide your EFC (Estimated Family Contribution) code report in your FASFA student aid report. All finalists will be asked to provide their student aid report to verify this figure.



Athletic Accomplishments
List your Athletic Accomplishments



Community Service Affiliations
List at least 3 Community Service Affiliations



Colleges / Universities
Applied to:
Accepted at:

Where do you plan to attend (If known):
What is your anticipated area of study (if known):


Application Signature
(Type your full name)



How did you hear about the BCCC Scholarship?






PLEASE SUBMIT SCHOLARSHIP APPLICATION NO LATER THAN APRIL 20th, 2018.

If you have any questions, please contact:
Josh@memorialbenefit.org

Thank you and good luck to all of our applicants.