naviance family connection - Austin ISD
naviance family connection - Austin ISD
naviance family connection - Austin ISD
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<strong>Austin</strong> Independent School District Scholarship Application<br />
Name of Scholarship: __________________________________________________________________<br />
Please type all information on both pages. Return the completed form to the counseling office at your<br />
school.<br />
Name: __________________________________Sex: _______Age: ______Ethnicity: ______________<br />
Last First<br />
Address: ________________________________________________________Phone:_________________<br />
Street City/State Zip<br />
Email Address:__________________________________________________________________________<br />
Names of schools attended:<br />
Elem._________________________________________Middle___________________________________<br />
High School Currently Attending: _________________________________________________________<br />
Mother Father Guardian<br />
__________________________ ________________________ _______________________<br />
Name Name Name<br />
__________________________ ________________________ _______________________<br />
Home Phone Home Phone Home Phone<br />
__________________________ ________________________ _______________________<br />
Address Address Address<br />
__________________________ ________________________ _______________________<br />
Occupation Occupation Occupation<br />
__________________________ ________________________ _______________________<br />
Business Phone/Ext. Business Phone/Ext. Business Phone/Ext.<br />
__________________________ ________________________ _______________________<br />
Email Address Email Address Email Address<br />
Number of adults and children who are dependent on parents’ financial support: _______________________<br />
Number of children dependent on parents’ financial support: ___________ Ages __,____,_____,____,____<br />
Number of <strong>family</strong> members attending college: _________________________________________________<br />
Describe any existing conditions that are causing unusual financial expenditures for any<br />
dependents listed above. Ex: illness, dental work, support of <strong>family</strong> by only one parent,<br />
etc.<br />
______________________________________________________________________________________<br />
______________________________________________________________________________________<br />
______________________________________________________________________________________<br />
______________________________________________________________________________________<br />
Please check approximate annual gross income in the home before deductions. Include all sources of<br />
income except earnings of minors in part-time employment.<br />
$0 to $15,000 _____ $45,001 to $55,000 _____ $75,001 to $85,000<br />
_____<br />
$15,001 to $30,000 _____ $55,001 to $65,000 _____ $85,001 to $95,000 _____<br />
$30,001 to $45,000 _____ $65,001 to $75,000 _____ $95,001 and above _____<br />
Education:<br />
Please list in order of preference:<br />
Colleges: 1.______________________2.______________________3.______________________<br />
Intended majors 1.______________________2.______________________3.______________________<br />
What are your career plans after college?<br />
For Office Use Only<br />
PSAT______________ SAT_____________ ACT____________ Rank______/_____<br />
GPA__________<br />
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