Revised  20xx
Choggiung Educational
Endowment Foundation
P.O. Box 330
Dillingham, Alaska 99576
Phone: 907-842-5218    Fax: 907-842-5462
contact@choggiung.com
20xx-20xy
Scholarship Application
Deadline for complete submittal is April 30, 20xx
➢ Your complete application must be received in the Choggiung Ltd. administrative office by April 30, 20xx.
➢ Email and/or faxed documents (not including the official transcript) are acceptable.
➢ It is your responsibility to make sure the complete application, including the official transcript, is received by Choggiung before the deadline. There are no exceptions.
➢ If mailing your application, please mail your application to our post office box.
***We will not contact you if your application is found to be incomplete***
If you have questions, ask well in advance of deadline.
SCHOLARSHIP INFORMATION
Eligible individuals include any Choggiung Ltd. Shareholder enrolled full-time in a qualifying post­secondary educational institution (college or vocational school).
In order to be qualified, the institute must meet the criteria defined in 26 U.S. Code section 170(b)(1)(A)(ii)*. Institutions include colleges, universities, vocational and technical schools.
Applicants must submit the following:
Selection of successful applicants will be the responsibility of the Choggiung Educational Endowment Foundation Comittee and is based upon prior academic performance, performance on tests designed to measure ability and aptitude for post-secondary work, recommendations from instructors, financial need and conclusions as to the applicant’s motivation, character, ability, potential, goals and expectations. Note that the criteria are not listed in order of priority or emphasis.
If you are awarded a scholarship, in accordance with the Internal Revenue Service’s rules, regulations, and required reporting; your name, address, and purpose of the grant will be disclosed in our tax return, which is made available for public inspection.
* Educational organization which normally maintains a regular faculty and curriculum and normally has a regularly enrolled body of pupils or students in attendance at the place where its educational activities are regularly carried on”, 26 U.S. Code section 170(b)(1)(A)(ii)
1
Revised  20xx
CHOGGIUNG EDUCATIONAL ENDOWMENT FOUNDATION
20xx-20xy SCHOLARSHIP APPLICATION
GENERAL INFORMATION
Name:
Address:
 
Birthdate:
Email:
Are you a Choggiung Shareholder:
Yes
No
 
Phone #
Are you related to any Choggiung Ltd. Board Member:
Yes
No
 
EDUCATIONAL PLANS
Name/Address of Institution that you plan to attend:
 
Type of Institution:
University/College
Junior College
Technical/Vocational
Expected Dates of Attendance:
Planned Field of Study:
Title of Degree/Certificate anticipated:
Current standing
i.e.; Freshman, Sophomore, Junior, Senior, Masters, Doctorate
EDUCATIONAL HISTORY
High School
Name/Address:
 
Dates of attendance:
 
Graduated:
Yes
No
 
Graduation date:
If No, GED or equivalent?
Significant Achievements:
 
Post Secondary
Name/Address of Institution:
 
Dates of attendance:
Field of Study:
Graduated:
Yes
No
 
Title of Degree/Certificate received:
Significant Achievements:
2
Revised  20xx
Post Secondary (Cont.)
Name/Address of Institution:
 
Dates of attendance:
Field of Study:
Graduated:
Yes
No
 
Title of Degree/Certificate received:
Significant Achievements:
 
Name/Address of Institution:
 
Dates of attendance:
Field of Study:
Graduated:
Yes
No
 
Title of Degree/Certificate received:
Significant Achievements:
(Use additional sheets as necessary)
EMPLOYMENT EXPERIENCE/HISTORY
Current Employer:
Address/Phone:
Dates of Employment:
Job Title:
Name of Supervisor:
Duties:
 
Past Employer:
Address/Phone:
Dates of Employment:
Job Title:
Name of Supervisor:
Duties:
 
Past Employer:
Address/Phone:
Dates of Employment:
Job Title:
Name of Supervisor:
Duties:
(Use additional sheets as necessary)
 
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Revised  20xx
Budget
The student may provide estimated amounts in all categories. Numbers must be reasonable and should reflect a full year or full term.
Income
Student's earnings to
 
be applied to schooling
Assistance from parent/guardian
Scholarships/Grants
Loans
Work Study
Other Income
Total
$
Expenses
Travel (to/from school)
Tuition/fees
Housing/Meals
Books/Supplies/Equip
Other expenses (list):
Total
$
Scholarships/Grants/Loans applied for (whether received or not):
References
Letters of Reference
You must provide a minimum of two letters of reference from individuals familiar with your abilities and who are not family members. Reference letters must be provided by the application deadline and should be attached to the application at the time of submittal.
Signature & Date
I certify that the information provided is accurate to the best of my knowledge and understand that providing false or misleading information may result in the rejection of my application. My signature also provides permission to Choggiung Limited d.b.a. Choggiung Educational Endowment Foundation to contact references,  employers, co-workers and students and/or staff of educational institutes listed on my application concerning myself.
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(unsigned)
Signature
Date
4
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