2019 UICCU Community Give & Grow Scholarship Program Thank you to all who applied for the 2019 Give & Grow Scholarship Program. Winner's will be announced in April 2019. Leave me blank for Give & Grow Scholarship. I have read and accept the requirements of these rules. * Entry Form General Information Name * Parent/Guardian Name * Address * City * State * - Choose a State - - Choose a State - Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code * Email * Phone * College Plans * Volunteer Information List up to three examples of significant community activities in which you have volunteered for during the past four years. Demonstrate a range of interests. Community Activity 1: Activity 1 Name of Activity Activity 1 Number of Years Participating Activity 1 Number of Hours Per Week (or) Activity 1 Total Number of Hours for Event Activity 1 Special Awards/Honors/Positions Community Activity 2: Activity 2 Name of Activity Activity 2 Number of Years Participating Activity 2 Number of Hours Per Week (or) Activity 2 Total Number of Hours for Event Activity 2 Special Awards/Honors/Positions Community Activity 3: Activity 3 Name of Activity Activity 3 Number of Years Participating Activity 3 Number of Hours Per Week (or) Activity 3 Total Number of Hours for Event Activity 3 Special Awards/Honors/Positions Extra-Curricular Activites Describe extra-curricular activities you have been involved in the last four years. List up to 9 entries. Extra-Curricular 1: Extra-Curricular 1 Name of Activity Extra-Curricular 1 Year Extra-Curricular 1 Description Extra-Curricular 2: Extra-Curricular 2 Name of Activity Extra-Curricular 2 Year Extra-Curricular 2 Description + ADD Extra-Curricular 3: Extra-Curricular 3 Name of Activity Extra-Curricular 3 Year Extra-Curricular 3 Description + ADD Extra-Curricular 4: Extra-Curricular 4 Name of Activity Extra-Curricular 4 Year Extra-Curricular 4 Description + ADD Extra-Curricular 5: Extra-Curricular 5 Name of Activity Extra-Curricular 5 Year Extra-Curricular 5 Description + ADD Extra-Curricular 6: Extra-Curricular 6 Name of Activity Extra-Curricular 6 Year Extra-Curricular 6 Description + ADD Extra-Curricular 7: Extra-Curricular 7 Name of Activity Extra-Curricular 7 Year Extra-Curricular 7 Description + ADD Extra-Curricular 8: Extra-Curricular 8 Name of Activity Extra-Curricular 8 Year Extra-Curricular 8 Description + ADD Extra-Curricular 9: Extra-Curricular 9 Name of Activity Extra-Curricular 9 Year Extra-Curricular 9 Description Essay The essay must be your original work. Please write up to 500 words in the space below. Tell us about your volunteer experience and why it is important to you. Essay Other Materials Please submit (under separate cover) your official high school transcript and a letter of recommendation electronically to: firstname.lastname@example.org or mail to: UICCU Attn: Community Relations Dept PO Box 800 North Liberty, IA 52317 All materials must be submitted by the deadline date of February 25, 2019. SUBMIT * required There was an error submitting the form Thank you for your application!