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SOUTHWEST CABLE COMMUNICATIONS ASSOCIATION
​.2023 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 7, 2023, 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 16, 2022. 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 7, 2023 .
​
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