2021 ccta scholarship application approved copy

CHAMPAIGN COUNTY TOWNSHIP
ASSOCIATION
SCHOLARSHIP PROGRAM


The CCTA will be offering two scholarships to
High School seniors in 2021. two $500.00
scholarships in two categories are being provided
this year. See below for eligibility requirements.

Eligibility
Student must be a U.S. citizen; reside in an Champaign
County, Ohio Township; and plan to attend a two or four
year college or university in the fall of 2021. Student
may apply for both scholarships, however , applications
and accompanying materials must be submitted in two
separate envelopes. Students can only win one of the two
scholarships.
Type
Academic Achievement Scholarship-Student must have
a B average (cumulative) and at least a 22 ACT or 1000
SAT score.

Requirements
Student Must Submit:
> Completed application form (see next page).
> Statement of activities, honors and leadership.
Including school and community activities.
and years in which you participated. Identify
leadership positions or awards you received.
> Copy of high school transcript, including ACT

and/ or SAT scores.
> Two letters of recommendation from teachers and/
or community leaders.
> A 500 word essay Academic Achievement Scholarship - describe
the importance of local government.
Community Involvement- Describe a community
project or event you participated in that impacted
your life.
Deadline
Completed applications must be received by Friday. April
9, 2021. Winners will be announced by Friday May 14, 2021

Remittance
All applications essays and materials listed in
requirements must be submitted to the Guidance
Counselors at the students local school.

CHECKLIST
Application form – signed and dated
Statement of activities, honors and leadership
Copy of high school transcript or equivalent
College admission test scores
Two letters of recommendation
Essay
 Please direct all questions relating to the CCTA scholarship program to your local
Champaign County Schools Guidance Counselor.


Submit all of the above items in one envelope by April 9, 2021

Name: _______________________________________________________________
Address: _____________________________________________________________
City. State, Zip:________________________________________________________
Phone: ______________________________ Email: __________________________
Township: ___________________________ County: ________________________
High School:__________________________________________________________
High School Address: __________________________________________________
GPA: ____________________ ACT: _______________ SAT: ________________
College/University Attending: ___________________________________________
College/University Address: ____________________________________________
Certification
I hereby certify that the information provided is truthful and accurate to the best
of my knowledge. I hereby apply for (choose one) the CCTA Academic Achievement
Scholarship _______, or the CCTA Community Involvement Scholarship ________.
Release of Information
By submitting the Champaign County Township Association scholarship application form
you are giving your consent for the CCTA to release your personal information to the
committee members who will be reviewing and scoring your information for scholarships
on behalf of the CCTA. Should you be selected to receive a scholarship, the CCTA may
request updates of your progress including GPA, classes taken, etc. Submission of this form
confirms you agree with these terms and conditions.
I have read and agree to the above terms and conditions.

Signature

Date


*Please note, all information submitted will be kept confidential and destroyed after the
scholarships have been awarded.