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Columbia-Greene Community College
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Title IX
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Scholarship Application

Name(Required)

First Middle Last

C-GCC Student ID

Date of Birth(Required)

Email(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Primary Phone Number(Required)

Alternative Phone Number

Registration Status(Required)

I have already registered for classes at C-GCC

No, I have not yet registered for classes at C-GCC

Student Type(Required)

Non-credit Student

Credit Courses

If you are a non-credit student please provide the non-credit course title(s), and course number(s) you are enrolled in(Required)

Have you submitted a FAFSA application for the current academic year?(Required)

Yes, I have submitted a FAFSA application

No, I haven't submitted a FAFSA application yet but I intend to

No, and I don't intend to apply for FAFSA

Have you ever attended Columbia-Greene Community College?(Required)

No, I have never attended Columbia-Greene Community College

Yes, I have previously attended Columbia-Greene Community College

If you answered yes to previously attending Columbia-Greene Community College please provide the approximate date you last attended(Required)

I am interested in receiving information regarding scholarships that require an additional essay(Required)

Yes

No

Additional Requirement(Required)

By checking this box, I acknowledge that, should I receive a scholarship, I am required to write a thank you note to the donor(s) explaining how the funding will help you reach your academic goals.

Acknowledgment(Required)

I acknowledge that I have read and agree to the above requirements

Initials(Required)

Date(Required)

MM slash DD slash YYYY

Authorization(Required)

I authorize C-GCC to release my statement of account to the C-GCC Foundation for purposes of scholarship and eligibility.

Initials(Required)

Date(Required)

MM slash DD slash YYYY

Δ

Columbia-Greene Community College

4400 Route 23
Hudson, NY 12534
518.697.6400

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