Rock Valley College
Rockford, Illinois

Scholarship Application

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A. Personal Information

(7-digit number, i.e. "0123456")

I would like to be considered for: (check all that apply)

Briefly describe what it will mean to you, your family and your community if you should receive an RVC Foundation private donor scholarship.

B. Student Information

Note: You must select exactly one of the following student types:

High School Student

Note: In order to be considered a recent High School graduate, you must have earned six (6) or less credit hours at Rock Valley College, and graduated from high school January 2013 or after. An official high school transcript, including the most recent Fall semester if a current student, is REQUIRED. You will not be considered without one.

New Adult Student


Returning Adult Student

C. Education Plans

My education plans at Rock Valley College:




My intention at RVC is to (select one):

            Degree I am pursuing:

            My area of concentration is:


                    AAS Program:


                    Certificate Program:

Please write a brief statement about your education and career goals.

D. Financial Need

Note: Not all of the RVC Foundation scholarships require documented financial need as shown by filing the FAFSA form (Free Application for Federal Student Aid). In order to be matched correctly to the available scholarships, you must choose one of the options below.

Financial Aid Information

        My EFC (Expected Family Contribution) is:

I understand that it must be completed before May 19, 2014 or I will not be considered for a need-based scholarship.

RVC Foundation scholarships will only pay a portion of your tuition, books, and fees. You will still be responsible for the remaining costs. The RVC Financial Aid office can help you with student loans and payment plans, so please plan now on how you will cover your educational expenses. How will you pay for your remaining education costs?

E. Scholarship Criteria

Many RVC Foundation Scholarships have a secondary set of preferred criteria that a donor would like to see met if at all possible. Some of this criteria can already be determined, such as living in a particular county, or graduating from a particular high school. Completing this section is not required, but it can improve your chances of receiving a scholarship.

Individual Preferences (check all that apply):

          Relationship:     Branch of Service:

          Relationship:     Branch of Service:

RVC Preferences (check all that apply):




Community Preferences (check all that apply):

          Name of publication:



F. Certification

I certify that the information on this form and all attached documentation is true and complete to the best of my knowledge.

I understand that by signing and submitting this scholarship application and supporting documents, I waive my rights to the Family Education Rights and Privacy Act (FERPA) for the purposes of selection and for providing recipient information to the donors of any scholarships I may be awarded. I also understand that my directory information and quotes from my application and submitted documentation may be used in publications, reports, press releases, etc. I addition, I give Rock Valley College permission to release my student education information to the Rock Valley College Foundation for the purpose of awarding and administering scholarships.

I further acknowledge that I will supply official transcripts and/or other required documentation to either the Rock Valley College Financial Aid Office or the RVC Foundation by the scholarship application deadline. I am aware that failure to do so may eliminate me for consideration of any scholarship awards that I may otherwise qualify for.

Finally, I realize that unless I am registered for fall classes by June 6, 2014 I will not be considered for a scholarship.


The Rock Valley College Foundation does not discriminate on the basis of race, color, creed, religion, national origin, disability, age, sex, marital status or sexual orientation.
Document Retention: All documents submitted to the Rock Valley College Foundation for scholarship purposes become the property of the Foundation. Documents will not be returned to students, nor will they be forwarded to other educational institutions or agencies.