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Name:
Student ID:
Address
Program of study
Year of study
Average from previous year
Academics awards received through high school
Value of current scholarships received this year:
No other scholarships
$1000 or less
$1001-$5000
$5001 or more
Are you involved with extra curricular activities on campus?
Please choose
No
Yes
If so, what extra curricular activites are you involved with?
List family members who studied at NSAC: include names, and your relationship.
CLASS YEAR IS REQUIRED.
Name
Class Year
Relationship
Please Choose
Grandparent/Great Grandparent
Parent
Sibling
Spouse
Aunt/Uncle (including grand aunt/uncle)
Cousin
Other
Please Choose
Grandparent/Great Grandparent
Parent
Sibling
Spouse
Aunt/Uncle (including grand aunt/uncle)
Cousin
Other
Please Choose
Grandparent/Great Grandparent
Parent
Sibling
Spouse
Aunt/Uncle (including grand aunt/uncle)
Cousin
Other
Please Choose
Grandparent/Great Grandparent
Parent
Sibling
Spouse
Aunt/Uncle (including grand aunt/uncle)
Cousin
Other
Please Choose
Grandparent/Great Grandparent
Parent
Sibling
Spouse
Aunt/Uncle (including grand aunt/uncle)
Cousin
Other
Please Choose
Grandparent/Great Grandparent
Parent
Sibling
Spouse
Aunt/Uncle (including grand aunt/uncle)
Cousin
Other
Please Choose
Grandparent/Great Grandparent
Parent
Sibling
Spouse
Aunt/Uncle (including grand aunt/uncle)
Cousin
Other
Please Choose
Grandparent/Great Grandparent
Parent
Sibling
Spouse
Aunt/Uncle (including grand aunt/uncle)
Cousin
Other
Please Choose
Grandparent/Great Grandparent
Parent
Sibling
Spouse
Aunt/Uncle (including grand aunt/uncle)
Cousin
Other
Please Choose
Grandparent/Great Grandparent
Parent
Sibling
Spouse
Aunt/Uncle (including grand aunt/uncle)
Cousin
Other
Please Choose
Grandparent/Great Grandparent
Parent
Sibling
Spouse
Aunt/Uncle (including grand aunt/uncle)
Cousin
Other
Please Choose
Grandparent/Great Grandparent
Parent
Sibling
Spouse
Aunt/Uncle (including grand aunt/uncle)
Cousin
Other
Please Choose
Grandparent/Great Grandparent
Parent
Sibling
Spouse
Aunt/Uncle (including grand aunt/uncle)
Cousin
Other
Family's support to NSAC and contribution to the Alumni Association
How are you financing your edication costs this year? Ex: Student loans, parents, self, scholarships or other.
Are there extenuating circumstances that the scholarship committee should be aware of in considering your application?
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