2022 Scholarship Application

2022 Scholarship Application

Name:

Email:

Home Phone: Birth Date:

Address: City:

Cell Phone:

State:

Zip:

High School: High School Address: City:

Graduation Date:

State:

Zip:

College/University/Trade School you plan to attend:

Major/Area of Study:

Are you a member of Premier Members Credit Union?

Yes

No

How did you find out about the scholarship?

NOTE: If you are awarded a scholarship, you will need to become a member of Premier Members Credit Union. For membership information, visit our website at or contact scholarship@ or 303.657.7304. All applicants will receive acknowledgment within 30 days of application due date.

By signing below, you certify that all information provided is truthful and complete, and that withholding pertinent information or providing false information is unlawful and may lead to disqualification. It is your responsibility to notify Premier Members Credit Union of any changes to the information prior to the deadline date. All application materials will be kept confidential and become the property of Premier Members Credit Union. Premier Members Credit Union will only use this information for the purpose intended and application materials will not be returned.

Student Signature

Date:

Parent Signature

Date:

Completed application forms and all supporting materials (see checklist) must be submitted together and received by April 1, 2022 to scholarship@.

Please direct questions to scholarship@ or 303.657.7304

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