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Home Address 1
Home Address 2
* New Jersey
Zip / Post Code
Applicant Cell Phone Number
Parent Email Address
Parent Phone Number
Tell us about the colleges you have applied to, listed in the order of preference:
Have you accepted an offer of admission?
If so, at which college?
Tell us what you and your family can contribute towards the cost of College:
Please enter values as numbers and decimal only. (e.g. 1000.00)
Totals will be calculated automatically.
Your own earnings/savings
Other Scholarships (specify)
If there is a funding gap between the total cost of your chosen college and the totals shown above, please describe your plans to offset this shortfall:
Parents Adjusted Gross Income
Parents Total Value of Cash & Investments
Parents Debt Obligations (including mortgage)
Students Adjusted Gross Income
Students Total Value of Cash & Investments
Please provide us with information about your siblings:
Please describe any extenuating financial circumstances that require you to seek financial aid: *
Please list any jobs you have held in the past two years:
Please tell us (1000 words or less) why the College Men’s Club should invest in you. * Please upload your Common Application essay. Agreement to Terms
The College Men’s Club of Westfield provides scholarship funds directly to a matriculating student, NOT to the college they plan to attend. If I am selected for a scholarship, I hereby certify that the scholarship funds will ONLY be used to defray the cost of enrollment as a full time student at an accredited college or university. I understand that if I withdraw as a full time student, the scholarship may be revoked at the discretion of the College Men’s Club of Westfield.
I also understand that during the term of the scholarship, it will be my obligation to maintain a satisfactory grade average, and, at the request of the Scholarship Committee, to forward a transcript of my grades to them. I will also keep the Scholarship Committee informed about my scholastic accomplishments, progress and plans (including transfer, disenrollment, etc.)
I hereby grant permission for the release to the College Men’s Club of Westfield, the following confidential information, and will assist them in obtaining this information:
Westfield High School Transcript
Standardized Test Scores (ACT, SAT)
I agree to all of the above terms
Name of Parent or Guardian who approves this submission