Nontraditional Scholarship Application

The FOCLA has a sholarship for students wishing to attend a nontraditional intitution. The student must be able to demonstrate a financial need for the scholarship. The student must have a mother, father, step-mother, step-father, sister, brother, grandmother or grandfather who has been employed, or is currently employed in a coal related industry.

First name

Middle name

Last name

Address

City

State

Zip Code

Home phone

Cell phone

Age

Date of Birth MM/DD/YYYY

Number in family

Family's yearly income

College you plan to attend

City

State

Type of school
Four year college or universityVocational/technical schoolBusiness collegeNursing schoolTwo-year community or junior college

Student:
First time studentReturning studentStudent will Live on campusLive off camCommute from home

Major course of study

Other educational institution

Community and volunteer activities, position held

Work Experience, position and brief description of your responsibilities

What is your personal reason for applying for this scholarship?

In your own words, what are the major obstacles facing the coal industry? (300 words)

Name of your relative who is currently employed or has been recently employed in a coal-related industry

Company’s name where your relative held a job