Scholarship Application
APPLICATIONS MUST BE POSTMARKED NO LATER THAN 06-08-2025
PLEASE RETURN APPLICATIONS TO:
New Jersey Gasoline, C-Store, Automotive Association Scholarship Committee
615 Hope Road, Bldg. 2, 1st Floor, Eatontown, NJ 07724
THIS APPLICATION IS BEING SUBMITTED THROUGH THE NJGCA MEMBERSHIP OF
NJGCA MEMBER NAME
NJGCA MEMBER ADDRESS:
APPLICANT IS SEEKING SCHOLARSHIP FOR (CHECK ONE OF THE FOLLOWING)
ATTENDING COLLEGE OR OTHER TRADE SCHOOL
ATTENDING AUTOMOTIVE TECHNICAL TRADE SCHOOL ONLY
PERSONAL INFORMATION
NAME
ADDRESS
HOME PHONE
CELL PHONE
EMAIL ADDRESS
SCHOOL PRESENTLY ATTENDING
PARENT/GUARDIAN'S NAME
PARENT/GUARDIAN ADDRESS, IF DIFFERENT FROM APPLICANT'S
PARENT/GUARDIAN HOME PHONE
PARENT/GUARDIAN CELL PHONE
PARENT/GUARDIAN EMAIL
SIBLING NAMES & AGES CURRENTLY ATTENDING COLLEGE (IF APPLICABLE)
ACADEMICS
MAJOR/INTENDED COURSE OF STUDY
CURRENT GPA
*PLEASE ATTACH OFFICIAL SCHOOL TRANSCRIPT WITH THIS APPLICATION
Only pdf, doc, docx and jpg are allowed
CLASS RANK (IF KNOWN)
SCHOOL CLUBS/SPORTS INVOLVED IN & DATES OF PARTICIPATION
EXTRACURRICULAR ACTIVITIES/COMMUNITY SERVICE & DATES OF PARTICIPATION
ANY SCHOOL HONORS/ACADEMIC AWARDS & DATES RECEIVED
FINANCIAL INFORMATION
FATHER/GUARDIAN OCCUPATION
MOTHER/GUARDIAN OCCUPATION:
PLEASE ENTER SCHOOL APPLICATIONS/ADMISSIONS INFORMATION IN THE TABLE BELOW
School name
Accepted? Y/yes N/no DK/don't know
Expected tuition per semester
Amount of school scholarship offered (if applicable)
Do you plan to attend?
Y/yes N/no U/undecided
NAME OF SCHOOL IF YOU ARE ALREADY IN POST-HIGH SCHOOL EDUCATION
EXPECTED GRADUATION DATE
TUITION COST PER SEMESTER OF COLLEGE OR TRADE SCHOOL YOU EXPECT TO ATTEND
CURRENT SCHOLARSHIPS AND AMOUNT OF EACH
AMOUNT OF STUDENT LOAN EACH SEMESTER (IF APPLICABLE)
DO YOU HAVE A PART-TIME/SUMMER JOB?
AVERAGE WEEKLY INCOME
PLEASE LIST ANY OTHER FINANCIAL SCHOLARSHIPS OR AWARDS AND AMOUNTS YOU ANTICIPATE RECEIVING
WHAT ARE YOUR OCCUPATIONAL GOALS POST- COLLEGE/TRADE SCHOOL?
ADDITIONAL APPLICATION INFORMATION/REQUIREMENTS
PLEASE WRITE AN ESSAY TO INDICATE YOUR MAJOR FIELD OF INTEREST AND EDUCATIONAL GOALS IN COLLEGE/TRADE SCHOOL USING 200 WORDS MINIMUM AND 300 WORDS MAXIMUM.
ALL SCHOLARSHIP MONIES RECEIVED SHALL BE AWARDED DIRECTLY TO THE SCHOOL OF YOUR CHOICE UPON RECEIPT OF COLLEGE ENROLLMENT.
APPLICANT NAME
APPLICANT SIGNATURE
By checking this box, you submit this as your digital signature and agree to abide by all terms herein.
DATE
I HAVE READ AN APPROVE OF THIS APPLICATION
PARENT GUARDIAN NAME
PARENT SIGNATURE
By checking this box, you submit this as your digital parental signature and agree to abide by all terms herein.
DATE