College Scholarships Application | Worth County Development Authority

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Worth County Development Authority
91 8th St N
Northwood, IA 50459

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Worth County Development Authority Scholarship Application
1. Student Name
2. Permanent Address
3. Phone Number
4. Parent Contact Phone Number
5. Social Security Number
6. School District
7. Have you resided with your parents/legal guardians in Worth County throughout grades 11 and 12? Please sign and have a school administrator sign here if you have.
Student signature:
School Adm.
8. College name and address where you plan to go? (Please attach acceptance letter to your application.)
9. Are there any special circumstances with this scholarship that the WCDA needs to know about? For example joining the army, etc. Worth County students have up to 4 years after graduation to take advantage of this scholarship.
Students must attend the awards ceremony in which the scholarship is given out or the student forfeits this scholarship. Checks will be made out directly to the college you will be attending. Letter of acceptance and class schedule is required to be in our office by September 1st of that school year. This form is due April 15th of your senior year. NO EXCEPTIONS. If April 15th falls on a weekend, applications are due the Friday prior by 4:00PM at the WCDA Office.
I, the undersigned, do acknowledge this information to be true and correct and I have read this form completely. I also agree at some point in my life to give back to my community by volunteering for a cause or helping in a positive way.
Parent's Signature
Student's Signature

Verification

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