Submit Broadcasting Scholarship Application

Application for WLJC Broadcasting Scholarship
Last Name:
First Name:
Middle Name:
Birth Date:
Home Address:
Home Telephone: () -
Cell: () -
Email address:
Name of parent(s) or legal guardian(s):
Address of parent(s) or legal guardian(s):
Current High School:
ACT or SAT score:
Grade level during the coming academic year:
Major/degree working toward:
List other financial assistance you will receive per semester:
College or University:
School Address:
  I hereby affirm that all the above stated information provided by me on this application is true, correct and without forgery. I also consent that my picture may be taken and used for any purpose deemed necessary to promote the WLJC Broadcasting Scholarship Program. I hereby understand that if chosen as a scholarship winner, I must provide evidence of enrollment/registration at the post-secondary institution of my choice before scholarship funds can be awarded.
  The following items must be mailed to WLJC, Scholarship committee, P.O. Box Y, Beattyville, Ky. 41311 * One letter of recommendation *Most recent official transcript of college or high school *500 word essay on why you are choosing a career in broadcasting