|  Area Lake Levels:  Bull Shoals Lake  |  Lake Norfork     
South Shore of Bull Shoals Lake, Arkansas
Home Environment South Shore Foundation Youth Adult Leadership Site Map

South Shore Foundation Academic Scholarship Application

Only students who are attending a South Shore area high school are eligible for this $1,000 scholarship. This includes students who are graduating or have graduated from Flippin, Yellville-Summit, Lead Hill, Omaha, Bruno-Pyatt and Bergman.

Deadline: March 31st
Turn in your application to your High School counselor. High School counselors must notify the South Shore Foundation of the winner by April 15th.

 Scholarship Application - Graduating Seniors

Student Name: ______________________   Parents Name: ______________________

_______ - _______ - _______ ________   ________ / ________ / _________
Social Security Number   Age Date of Birth

Permanent Address (Parents or Student): ____________________________________

City: _____________________________     State: ________________     Zip: ________________

State & County of Legal Residence: __________________________________________________

___________________     ___________________    
Home Phone #      Cell Phone #  

Today's Date: _____ / _____ / ______    South Shore High School:_______________

College Expected to Attend: _______________________________________________
College Address: _____________________________________

City: _____________________ State: __________________ Zip: _______________

Major: _____________________________________________________________

Expected Date of Graduation: _______________       High School        College

Estimated cost per semester: Tuition & Fees _________________     Room & Board ___________________

  Books ________________________  Total Est. _______________________

_______________________          ___________          ___________________          ____________
High School Grade Point              ACT Scores            SAT Composite Score           College GPA
Average (From Transcript)            (Highest)                 (Highest)

Seniors:
    *Enclose a Current Official High School Transcript & ACT/SAT Scores.
    *Enclose Proof of Admission to College, if Available.

Will you be employed while attending college?: _____________

Employer: ___________________________________________

Phone #: ___________________

Number of hours worked per week: _________________
 

 Extra Curricular Achievements

_____________________________________________

_____________________________________________
 
_____________________________________________

_____________________________________________

_____________________________________________

_____________________________________________
 

 Scholarship Information

Have you received or are you going to receive any other scholarships?  yes_____ no_____
Please list with $ amounts.(Do not include loans or work study information)

___________________   ___________________      $_________________
Title of Scholarship   Source of Scholarship Amount/year

___________________      ___________________       $_________________
Title of Scholarship   Source of Scholarship Amount/year

___________________     ___________________      $_________________
Title of Scholarship   Source of Scholarship Amount/year

 

 Statement of Need

Write a letter from yourself stating your need for this scholarship, plans for your education, and your future career.
 



 

The South Shore Academic Scholarship Financial Statement

The Financial Statement of (parent's or guardian name or student's name):____________________

Address: __________________________________________________________________________

Telephone Numbers - Home: __________________________  Cell: __________________________

RE: Application of: __________________________________________________________________
                                                                     (Name of Student)

Assets:

Cash in Banks .............................................       ________________________
Notes and Loans Receivable ..........................       ________________________
Marketable Securities ...................................       ________________________
Restricted Securities ....................................       ________________________
Commercial Real Estate ...............................       ________________________
Home, Home Furnishings, Automobiles .........       ________________________
Equity in Private Business ............................       ________________________
Other (Describe, e.g. beneficiary of trust) .......       ________________________
Total Assets..............
      ________________________

Liabilities:

Note or Mortgage Payable on Home,
Home Furnishings, and/or Automobiles ...................
      ________________________
Other Notes and Loans Payable ............................       ________________________
Other Mortgages Payable .....................................       ________________________
Other Liabilities (Describe) ____________ ...........       ________________________
Total Liabilities ................
      ________________________
Net Worth (Assets minus Liabilities) .......................       ________________________

 

The preceding Financial Statement accurately and completely sets forth my present assets, liabilities, and net worth. I represent that: (a) the information contained herein is complete and accurate and may be relied upon by the Trustee's, and; (b) I will notify the Trustee's immediately of any material change in any such information occurring after the date of submission of this statement.

_______________________________________ 
Signature                                                      

_______________________________________ 
Relationship to Applicant      
                          

 


  

 
Online Driving Tours Area Calendar Please Contact Us

South Shore • 301 East Main Street • P.O. Box 209 • Flippin, AR 72634
Phone: (870) 453-8800 • Toll Free: 1-800-775-6682

Home | Bull Shoals Lake | White River | Online Driving Tours | What's New
Youth Leadership | Adult Leadership | Area Calendar | Environment | Foundation
History | Site Map | Local Businesses Online | NATCO Portal Page | Useful Links

South Shore was founded by and is fully supported by NATCO
(Northern Arkansas Telephone Company).

NATCO Communications
Harrison Convention & Visitor's Bureau
South Shore of Bull Shoals Lake, Arkansas South Shore of Bull Shoals Lake, Arkansas