Testing Page – Security First Credit Union

All fields with * are required

Account Information

*SFCU Account Number:

*Relation to Account Provided:

*Which Best Describes You: First Time ApplicantPrevious ApplicantPrevious Recipient

If applicable, please provide account information for immediate household members that also have an account at Security First Credit Union:

SFCU Account Number:

Length of Membership
(months):

SFCU Account Number:

Length of Membership
(months):

SFCU Account Number:

Length of Membership
(months):

All fields with * are required

Applicant Information

*First Name:	Middle Initial:	*Last Name:
*Primary Phone Number:	Alternate Phone Number:	*Email Address:
*Date of Birth (If using Internet Explorer use the following format YYYY-MM-DD):

Permanent Address

*Street:

*City:

*State:

*Zip:

*Father/Guardian Name:

*Occupation:

*Mother/Guardian Name:

*Occupation:

All fields with * are required

Education History

*First Generation College Student: YesNo

*Number of Siblings Currently in College:

Are you enrolled in an accredited Rio Grande Valley (Hidalgo, Willacy, Starr & Cameron County) high school? YesNo

School Name:

Grade Classification: FreshmanSophomoreJuniorSenior

High School Address
Street:	City:	State:	Zip:

Are you enrolled in an accredited university/college? YesNo

Total of college hours earned:

School Name:

Grade Classification: FreshmanSophomoreJuniorSenior

University/College Address
Street:	City:	State:	Zip:

If you are not currently attending university/college, which college, university, technical, or other post-secondary education institution do you plan to attend?

1st Choice:

2nd Choice:

If Yes, to where:

Have you been accepted for admission? YesNo

Estimated tuition cost for 1 year: 0 - 15k15 - 30k30k - above

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Section A: Extra Curricular Activities/Awards

List any high school or college organizations, or activities with which you have been involved.

Name of Organization/Club:

Elected position(if applicable):

Dates
(If using Internet Explorer use the following format YYYY-MM-DD):

From:		To:
From:		To:
From:		To:
From:		To:
From:		To:
From:		To:

All fields with * are required

Section B: Community Involvement

List any community involvement in which you have been involved:

Activity:

Years:

Hours:

All fields with * are required

Section C: Honors and Awards

Please list significant honors, awards, and achievements you have received during high school/college:

Honor/Award:

Basis for Award:

Year Received:

All fields with * are required

Section D: Work History - Paid or Volunteer Hours

Please list any jobs you have held or are currently holding. Provide a brief description of your position and responsibilities, dates of employment, and hours worked weekly, monthly or annually.

Place of Business:

Position:

Responsibilities Held:

Dates
(If using Internet Explorer use the following format YYYY-MM-DD):

From: Hours Worked:		To: Period:
From: Hours Worked:		To: Period:
From: Hours Worked:		To: Period:
From: Hours Worked:		To: Period:

All fields with * are required

Section E: Extenuating Circumstance

Reference form must be completed by teachers, counselors, employers, or community leaders and submitted to Security First Credit Union no later than April 20, 2018.
Please confirm that the email addresses provided are correct as all reference forms will be emailed directly to them by Security First Credit Union. 1400

All fields with * are required

Section F: File Uploads

A copy of an official or unofficial transcript.
A minimum one-page typed essay per topic specified.
Letter(s) of acceptance.
Reference Letters.

*Transcript:
*Essay:
*Acceptance Letter:
References:

All fields with * are required

Section G: Certification

I certify that all information provided on this application and all supporting documents are accurate and complete. I understand that any misleading or false information will result in my application being disqualified. If selected as a scholarship winner, Security First Credit Union reserves the right to use selected applicants name and any likeness thereof for promotional purposes, including, but not limited to social media, print and web.

Applicant Signature:
Parent/Legal Guardian Signature(if applicant is under age 18) :

All fields with * are required

Account Information

*SFCU Account Number:

*Relation to Account Provided:

*Which Best Describes You: First Time ApplicantPrevious ApplicantPrevious Recipient

If applicable, please provide account information for immediate household members that also have an account at Security First Credit Union:

SFCU Account Number:

Length of Membership
(months):

SFCU Account Number:

Length of Membership
(months):

SFCU Account Number:

Length of Membership
(months):

All fields with * are required

Section F: File Uploads

A copy of an official or unofficial transcript.
A minimum one-page typed essay on the topic specified.
Letter(s) of acceptance.

*Transcript:
*Essay:
*Acceptance Letter:
References:

*Name:

*1:
*2:
*3:

*Email:

*Phone:

Applicant Acknowledgment

I Agree

Parent/Legal Guardian Acknowledgment (if applicant is under age 18)

I Agree

*Best Contact Number:	*Preferred Appointment Date (yyyy-mm-dd format):	*Preferred Time:
*How can we be of assistance?	Additional information:

Your Name:	Primary Account HolderJoint Account Holder Your Account Number:
Your Email:	Which branch do you primarily visit:

Account Information

Applicant Information

Permanent Address

Education History

High School Address

University/College Address

Section A: Extra Curricular Activities/Awards

Section B: Community Involvement

Section C: Honors and Awards

Section D: Work History - Paid or Volunteer Hours

Section E: Extenuating Circumstance

Section F: File Uploads

Section G: Certification

Account Information

Section F: File Uploads

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