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

*E-mail

*Address

*City

State

*Zip Code

*Home phone

*Age

*Number in family

*Cell phone

*Date of Birth

*Family's yearly income

*College you plan to attend

*City

*State

*Type of school

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