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Oregon Pacific Bank Scholarship Application
Submitter Information
First Name (required)
Last Name (required)
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Cell #Home #Email
Contact Information
 
Mailing Address (required)
Please identify which geographical area your High School is located in to confirm eligibility (required)
 
 
(required)
NamePhone #EmailOccupation
Mother
 
Father
 
Guardian (if any)
 
Best Mailing Address to Contact Parents or Guardian (required)
Name of High SchoolGPA
High School Information
 
Address of High School (required)
Colleges/Universities/Vocational Schools under consideration, listed by priority
Institution NameLocation

 

 

 

 
Major Field of StudyExpected DegreeCareer Goal(s)

 
Are you currently working, or have you worked during high school? Please give us details on places of employment, duration, and type of work.
Place of WorkDurationType of Work

 

 

 
Estimated $ Amount
Tuition and Fees
 
Room and Board
 
Books and Supplies
 
Transportation
 
Anticipated Personal Expenses (clothing, laundry, recreation, etc.)
 
Unusual or major expenses for which applicant is responsible
 
Total estimated financial need per year of college
 
Other Resources
DetailsEstimated $ Amount
Scholarship(s)
 
Loan (s)
 
Savings
 
Family Financial Assistance
 
Work/Study
 
Employment
 
Other
 
If family cannot assist financially, please explain:
Siblings/others dependent on the family:
NameRelationshipAge

 
Please select one: (required)
Please provide a brief 4 paragraph maximum essay that shares information about you that is not evident in the rest of this application, including school experiences, community activities, honors to date, extracurricular activities, positions of responsibility, club, athletics, etc. (required)
You MUST include your GRADE TRANSCRIPTS, TWO signed letters of RECOMMENDATION, and any additional documents you'd like to include with your application here. (required)
Grade Transcripts and two signed letters of recommendation are required.
All statements in this application are correct to the best of my knowledge. (required)
Applicant Signature
Applicant NameDate of Application