Iowa Central General Scholarship Application

Please read carefully before filling out the application below. It is important to know the following:

• It is recommended that you visit this page on a non-mobile device when filling out the form below
• Review complete application before starting to be aware of requirements of each section
• Set aside adequate time to fill out the application completely with details
• You can NOT save the application and return to it
• There is no time limit. Take your time filling it out
• * indicates a required field

* Select the center you plan to attend: Please make a selection Fort Dodge Storm Lake Webster City Please select an item.

* Semester you are applying for: Select a term Fall Spring Please select an item.

* Year you are applying for: 20  A value is required.

* Are you considered... Select Residency Status In-state Resident Out-of-state Resident Please select an item.

* First Name: A value is required.

* Last Name: A value is required.

Middle Initial: 

Maiden or Other: 

* Birthdate: A value is required.Invalid format.

*  Phone: A value is required.Invalid format.

* Permanent Street Address: A value is required.

* Permanent City:  A value is required.

* Permanent County: A value is required.

* Permanent State: A value is required.

* Permanent Zip Code: A value is required.

Local Street Address:

Local City:

Local County:

Local State:

Local Zip Code:

* Email: A value is required.Invalid format.

*  Proposed college major: A value is required.

* Have you filed a FAFSA? Make a selection Yes No Please select an item.

* Are you a returning Iowa Central student? Make a selection Yes No Please select an item.

* Explain how a scholarship will help you financially? Feel free to share any unusual circumstances.

Please indicate the activities and/or athletics you plan to participate in:

Athletic Manager
Cheerleading (Co-Ed)
Music-Instrumental
Music-Vocal

Newspaper (Collegian)
Student Ambassador
Student Government
Theatre

Men's Intercollegiate Athletics:

Baseball
Basketball
Bowling
Cheer
Cross Country
Dance Team
eSports
Football
Golf

Marching Band
Rodeo
Rugby
Soccer
Sports Shooting
Swimming
Tennis
Track and Field
Wrestling

Women's Intercollegiate Athletics:

Basketball
Bowling
Cross Country
Cross Country
Dance Team
eSports
Golf
Marching Band

Rodeo
Soccer
Softball
Sports Shooting
Swimming
Tennis
Track and Field
Volleyball
Women's Wrestling

* High School: A value is required.

* High School City: A value is required.

* High School State: A value is required.

* Graduation Year: A value is required.

High School GPA:

Class Rank:

If returning or transferring please enter your cumulative GPA:

By checking this box I certify that all the information above is correct and will serve as my electronic signature.
You must check the box to continue.

Please fill out the fields indicated above!
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It is the policy of the Iowa Central Community College not to discriminate in its programs, activities, or employment on the basis of race, color, national origin, sex, disability, age, sexual orientation, gender identity, creed, religion, and actual or potential family, parental, or marital status.

If you have questions or complaints related to compliance with this policy, please contact Stacy Ihrig, Human Resources, 515-574-1138, ihrig@iowacentral.edu, or the Director of the Office for Civil Rights U.S. Department of Education, Citigroup Center, 500 W. Madison Street, Suite 1475, Chicago, IL 60661-7204, Telephone: (312) 730-1560 Facsimile: (312) 730-1576, Email: OCR.Chicago@ed.gov.