Scholarship Application

STUDENT INFORMATION

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State ZIP Code

Date of Birth(Required)

Phone(Required)

Email(Required)

Academic Information

High School(Required)

High School Address(Required)

Street Address City State ZIP Code

Graduation Date(Required)

High School / College GPA(Required)

ACT/SAT Score(Required)

School / College Planning to Attend(Required)

Note: You must attend a school in Alabama to be considered for the scholarship.

Are you currently enrolled in this school?(Required)

Yes

If so, what will be your status in the fall?

Freshman

Sophmore

junior

Senior

Will you / do you work while attending school?

Yes

If yes, where?

How many hours do you work per week?

Planned / Current field of study(Required)

Note: Planned field of study must be construction-related. Consideration will be given to students who plan to study in the two-year trades and those four-year students already accepted into their construction-related intended field of study

Career Objective(Required)

FAMILY INFORMATION

Are you a dependent (do your parents / guardians pay your expenses)?(Required)

Yes

Parents or Guardians

Father

Living

Deceased

Name

First Last

Address

Street Address Address Line 2 City State ZIP Code

Occupation

Mother

Living

Deceased

Name

First Last

Address

Street Address Address Line 2 City State ZIP Code

Occupation

Marriage Status/ Dependents

Marriage Status(Required)

Single

Married

Spouse(Required)

Living

Deceased

Name(Required)

First Last

Occupation(Required)

Do you have Dependents(Required)

Yes

Number of Dependents(Required)

Age of Dependent(Required)

Ages of Dependents(Required)

ASSET INFORMATION

How do you plan to finance your education? Please fill in percentage totals that apply. (ie. 25% Loans, 25% Scholarships, 50% Family Contribution. Combination totals must equal 100%)

Percentage from Loans

Please enter a number less than or equal to 100.

Percentage from Scholarships

Please enter a number from 0 to 100.

Percentage from Family Contributions

Please enter a number from 0 to 100.

Percentage from Personal Contributions

Please enter a number from 0 to 100.

Additional Information

Is any member of your family an AGC Member?

Yes

AGC Member Name

First Last

AGC Chapter/ Section

Which AGC Member Recommended You

First Last

Please describe your career goals as they relate to the construction industry and what this scholarship award means for you(Required)

Applicant Must Provide the following

Copy of college or high school transcripts (whichever is most recent)(Required)

Max. file size: 25 MB.

Minimum of Two letter of recommendation(Required)

Drop files here or

Max. file size: 25 MB.

Proof of residency (example: copy of state issued identification/license, etc.)(Required)

Max. file size: 25 MB.

CERTIFICATION AND AUTHORIZATION I hereby certify that the information contained in this application is true and correct. I authorize the scholarship committee to make such investigation of this application as it deems appropriate, to include the contacting of any of the individuals or institutions referred to in the application. I also give my consent for the transmittal or communication to the scholarship committee by any academic institution that I have attended of grade, class standing or quality grade information, as well as information concerning extracurricular activities. I understand that the falsification of any information contained in this application will disqualify me from further consideration or receipt of funds from the scholarship.

Signature of Applicant(Required)

Date

Scholarship Application