General Scholarship

Application Form

PLEASE NOTE:

Completing this application does not guarantee that you will receive a scholarship. Scholarships are awarded based on unique criteria, and the number of awards is limited.
This application is for currently enrolled students and new students who plan to attend Cayuga Community College.

Applicant Information

First Name:

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Provide your First Name

Required Field

Middle Name:

Last Name:

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Provide your Last Name

Required Field

Date of Birth:

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Provide your Date of Birth

Required Field (MM-DD-YYYY format)

Personal Email Address:

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Provide your Email Address

Required Field

Phone Number:

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Provide a Phone Number

Either Phone or Mobile Phone is required

Mobile Number:

High School Education

If you attended High School, please provide the following information:

High School Name:

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Provide your High School Name

Required Field

High School City:

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Provide your High School City

Required Field

High School State:

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Provide your High School State

Required Field

Attended From:

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Provide Starting Year

Required Field

To:

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Provide Ending Year

Required Field

Overall Cumulative Average:

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Provide Overall Average

Required Field

Cayuga Student Information

If you are a current Cayuga student, please provide the following information:

College Email Address:

College ID (C-Number):

I am currently:

First Year Student

Second Year Student

Degree Program:

Current GPA:

Total Enroll Credits:

NOTE: Some scholarships require that FAFSA be completed.

FAFSA Completed:

Yes

TAP Completed:

Yes

Mailing Information

Apartment Number:

PO Box:

Street Address:

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Provide your Street Address

Required Field

City:

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Provide your City

Required Field

State:

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Provide your State

Required Field

Zip Code:

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Provide your Zip Code

Required Field

County:

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Provide your County

Required Field

Are you a citizen of the United States?

Yes

Required Field

Student Digital Signature

Type your LEGAL name as your signature:

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Provide your Signature

Required