2021 Scholarship Application
To apply for the Southwest Cable Communications Association scholarship, the applicant:
1. Must be an employee of a SWCCA member. The employee must have at least one year continuous service with their respective company and continue to be employed by said company the date the scholarship is awarded
or
Must be a dependent of an employee of a SWCCA member. The employee must have at least one year of continuous service with their respective company and continue to be employed by said company the date the scholarship is awarded.
2. Must enroll in an accredited junior college, college or university within the State of Arizona or New Mexico for nine hours or more of credit courses oriented toward a degree program.
3. Must have a demonstrated financial need.
4. Must complete scholarship application and return it with appropriate supporting data (including transcripts) no later than April 16, 2021, to the Southwest Cable Communications Association office at 5111 N. Scottsdale Rd. - Suite 260, Scottsdale, Arizona 85250.
Scholarship amount is $1,500 and will be paid to the recipient upon confirmation of enrollment. Recipients are limited to receiving scholarships to no more than one year. The Association’s Selection Committee will review and acknowledge all applications; the recipient will be named by May 14, 2021. Additional applications and information may be obtained from the Southwest Cable Communications Association at 5111 N. Scottsdale Rd. - Suite 260, Scottsdale, Arizona 85250, (602) 955-4122, or on our website at www.swcable.org.
NAME _____________________________________________________________________
Last First Middle
ADDRESS __________________________________________________________________
__________________________________________________________________
City State Zip
EMAIL_____________________________________________________________________
TELEPHONE _________________ S.S.# ________________ BIRTH DATE _____________
PARENT(S)/LEGAL GUARDIAN _________________________________________________
ADDRESS __________________________________________________________________
__________________________________________________________________
City State Zip
INDUSTRY AFFILIATION (Company) ____________________________________________
ADDRESS __________________________________________________________________
City State Zip
TELEPHONE ________________________ POSITION _____________________________
DATE EMPLOYED ___________________________________________________________
If Dependent, Name of Employee & Relationship to Applicant:_________________________
HIGH SCHOOL ______________________________________________________________
Name City State
DATE OF GRADUATION ______________________________________________________
CUMULATIVE GPA _________________ CLASS RANK __________________
** Must Attach “OFFICIAL” certified copies of high school transcripts or college transcripts. (Application will be void if this information is not attached or sent before deadline.)
PLAN TO ATTEND __________________________________________________________
Name of college, university, junior college
** Attach evidence of acceptance if available.
INTENDED MAJOR __________________________________________________________
ACADEMIC HONORS AND AWARDS:
Please indicate any awards, honors or recognitions received.
EXTRA CURRICULAR ACTIVITIES:
Please indicate any extracurricular activities - clubs, athletics, student government, music organizations, etc.
CAREER OBJECTIVES:
Please explain your career and employment objective and the relationship between your academic program
and your goals. Use additional pages if necessary.
WORK EXPERIENCE:
Please list work experience starting with current or most recent employment. Indicate dates, employer, and
job responsibilities.
FINANCIAL NEED:
Please describe your financial need for this scholarship assistance.
REFERENCES:
Please list two references. One should be a teacher or a supervisor who would have knowledge of your ability
to pursue the course of study you have selected.
Name ____________________________________________________________________________
Address __________________________________________________________________________
Relationship __________________________________ Phone ______________________________
Name ____________________________________________________________________________
Address __________________________________________________________________________
Relationship __________________________________ Phone ______________________________
I authorize the use of my scholarship application in the evaluation process of the Southwest Cable Communications Association scholarship program. I declare that, to the best of my knowledge, the information provided on this form is correct and complete. I also authorize the release of publicity about me if I am the recipient of the scholarship.
SIGNATURE _______________________________________ DATE ______________________
(If applicant is a dependent of a cable employee):
I, the parent of the scholarship applicant, declare that, to the best of my knowledge, the information provided on this form is correct and complete, and I certify that the information regarding my employment within the cable industry is true and correct. I consent to the use of the information provided on this form in connection with scholarship program and consent to the release of publicity about my child if my child is the recipient of the scholarship.
SIGNATURE OF PARENT ___________________________________ DATE _______________
Applications and transcripts must be returned to the Southwest Cable Communications Association’s office at:
5111 N. Scottsdale Rd. – Suite 260, Scottsdale, Arizona 85250 by April 16, 2021 .
1. Must be an employee of a SWCCA member. The employee must have at least one year continuous service with their respective company and continue to be employed by said company the date the scholarship is awarded
or
Must be a dependent of an employee of a SWCCA member. The employee must have at least one year of continuous service with their respective company and continue to be employed by said company the date the scholarship is awarded.
2. Must enroll in an accredited junior college, college or university within the State of Arizona or New Mexico for nine hours or more of credit courses oriented toward a degree program.
3. Must have a demonstrated financial need.
4. Must complete scholarship application and return it with appropriate supporting data (including transcripts) no later than April 16, 2021, to the Southwest Cable Communications Association office at 5111 N. Scottsdale Rd. - Suite 260, Scottsdale, Arizona 85250.
Scholarship amount is $1,500 and will be paid to the recipient upon confirmation of enrollment. Recipients are limited to receiving scholarships to no more than one year. The Association’s Selection Committee will review and acknowledge all applications; the recipient will be named by May 14, 2021. Additional applications and information may be obtained from the Southwest Cable Communications Association at 5111 N. Scottsdale Rd. - Suite 260, Scottsdale, Arizona 85250, (602) 955-4122, or on our website at www.swcable.org.
NAME _____________________________________________________________________
Last First Middle
ADDRESS __________________________________________________________________
__________________________________________________________________
City State Zip
EMAIL_____________________________________________________________________
TELEPHONE _________________ S.S.# ________________ BIRTH DATE _____________
PARENT(S)/LEGAL GUARDIAN _________________________________________________
ADDRESS __________________________________________________________________
__________________________________________________________________
City State Zip
INDUSTRY AFFILIATION (Company) ____________________________________________
ADDRESS __________________________________________________________________
City State Zip
TELEPHONE ________________________ POSITION _____________________________
DATE EMPLOYED ___________________________________________________________
If Dependent, Name of Employee & Relationship to Applicant:_________________________
HIGH SCHOOL ______________________________________________________________
Name City State
DATE OF GRADUATION ______________________________________________________
CUMULATIVE GPA _________________ CLASS RANK __________________
** Must Attach “OFFICIAL” certified copies of high school transcripts or college transcripts. (Application will be void if this information is not attached or sent before deadline.)
PLAN TO ATTEND __________________________________________________________
Name of college, university, junior college
** Attach evidence of acceptance if available.
INTENDED MAJOR __________________________________________________________
ACADEMIC HONORS AND AWARDS:
Please indicate any awards, honors or recognitions received.
EXTRA CURRICULAR ACTIVITIES:
Please indicate any extracurricular activities - clubs, athletics, student government, music organizations, etc.
CAREER OBJECTIVES:
Please explain your career and employment objective and the relationship between your academic program
and your goals. Use additional pages if necessary.
WORK EXPERIENCE:
Please list work experience starting with current or most recent employment. Indicate dates, employer, and
job responsibilities.
FINANCIAL NEED:
Please describe your financial need for this scholarship assistance.
REFERENCES:
Please list two references. One should be a teacher or a supervisor who would have knowledge of your ability
to pursue the course of study you have selected.
Name ____________________________________________________________________________
Address __________________________________________________________________________
Relationship __________________________________ Phone ______________________________
Name ____________________________________________________________________________
Address __________________________________________________________________________
Relationship __________________________________ Phone ______________________________
I authorize the use of my scholarship application in the evaluation process of the Southwest Cable Communications Association scholarship program. I declare that, to the best of my knowledge, the information provided on this form is correct and complete. I also authorize the release of publicity about me if I am the recipient of the scholarship.
SIGNATURE _______________________________________ DATE ______________________
(If applicant is a dependent of a cable employee):
I, the parent of the scholarship applicant, declare that, to the best of my knowledge, the information provided on this form is correct and complete, and I certify that the information regarding my employment within the cable industry is true and correct. I consent to the use of the information provided on this form in connection with scholarship program and consent to the release of publicity about my child if my child is the recipient of the scholarship.
SIGNATURE OF PARENT ___________________________________ DATE _______________
Applications and transcripts must be returned to the Southwest Cable Communications Association’s office at:
5111 N. Scottsdale Rd. – Suite 260, Scottsdale, Arizona 85250 by April 16, 2021 .
