SCHOLARSHIP PROGRAM and APPLICATION



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Tennessee Gas Association Scholarship Foundation SCHOLARSHIP PROGRAM and APPLICATION (COLLEGE/UNIVERSITY APPLICANTS) 83 CENTURY BOULEVARD NASHVILLE, TN 37214 (615) 872-2411 jwellman@tngas.org www.tngas.org Rev 1-2015

The Tennessee Gas Association (TGA) has established a Scholarship Foundation. The Foundation has been established to offer assistance to academically qualified students to continue pursuing a degree at a two- or four-year accredited university, college, or technical school. Scholarships will be based on such criteria as academic achievement, financial need, extra-curricular activities, community involvement, etc. The Foundation has been established by the direct efforts of the TGA Scholarship Committee and monies raised from the TGA Annual Scholarship Golf and Fishing Tournaments, Silent Auctions and individual member contributions. SCHOLARSHIP INFORMATION: All but two scholarships will be awarded in the amount of $2,000. Two scholarships will be awarded in the amount of $3,000 the John Ward Scholarship and the Leslie B. Enoch, II Scholarship. Check written payable jointly to the scholarship recipient and the educational institution they attend, and will require the endorsement of both parties. Awarded at the discretion of the Tennessee Gas Association Scholarship Foundation. Amount to be awarded is determined annually based on funds available. Recipients notified on or about May 1 st. ELIGIBILITY (VERY IMPORTANT, PLEASE READ) To be considered for the TGA Foundation Scholarship, the applicant: must be a dependent child of a natural gas distribution or pipeline system full-time employee who has been continuously employed for at least one year with that system, and where that system is a multiple distribution utility, works for the natural gas division of that system. The distribution system must be located within the state of Tennessee and be a member in good standing with the Tennessee Gas Association. Also, the employee and dependent child must reside within the state of Tennessee to be eligible, or; must be a dependent child of an affiliate member or marketer member company employee who has been continuously employed for at least one year with that company. The company must be a member in good standing with the Tennessee Gas Association. Also, the employee and dependent child must reside within the state of Tennessee to be eligible. must be a current student in good standing, in accordance with current institutional policies, with a grade point average of 3.0, or higher. must be a full-time student enrolled for 12 or more hours at an accredited university, college, or technical school. must complete pages 3-5 of the TGA Foundation Scholarship application and submit prior to March 31, PLEASE NOTE: Complete Applications submitted to TGA by the March 31 deadline will be given every consideration by the Scholarship Foundation, but please be advised that submitting an application does not automatically guarantee you will receive a scholarship. The Scholarship Foundation reserves the right to determine, based on criteria outlined, scholarship recipients. TENNESSEE GAS ASSOCIATION SCHOLARSHIP FOUNDATION 2

SCHOLARSHIP APPLICATION (COLLEGE/UNIVERSITY STUDENTS) Application deadline is March 31 APPLICATIONS POST MARKED AFTER MARCH 31 WILL BE INELIGIBLE, AS WILL INCOMPLETE APPLICATIONS Name Address City State Zip Home Phone Cell Phone Email County Date of Birth College/University Anticipated Graduation Date: College/University Address (include Street, City, State, Zip) Registrar & Phone Number Name of your local newspaper publication FAMILY INFORMATION IMPORTANT: One parent must be employed by the NATURAL GAS division of a TGA Member company Father or Guardian Mother or Guardian Name Email Employer Title Please fill in current information about yourself and any siblings in your family in the space provided below. Also, if any other individual in your household will attend college this year and list the college. Full Name Age Relationship to College Student 1. 2. 3. 4. Check this box if there are additional family members not listed above and attach a separate list. 3

EDUCATIONAL PLANS Attending College, University, or Technical School Major Term to be enrolled What are your plans to continue your education? What are your career goals? ACTIVITIES List any extra-curricular groups, organizations, student government, or other activities at school in which you have participated or honors you have received. List any involvement in community activities and/or work experience. GENERAL State briefly what it would mean to you to be awarded a scholarship (attach an additional page if necessary). FINANCIAL INFORMATION Combined Family income (including both parents/guardians): $0 - $50,000 over $50,000 Have you completed the Free Application for Federal Student Aid (FAFSA) for the upcoming term? Yes, No List any other financial assistance for which you have applied or plan to apply. 4

SIGNATURE AND CERTIFICATION I certify that none of the information provided on this application is false nor have I willingly withheld any pertinent information. I will use scholarship funds for educational purposes only. I give permission for information to be given to the appropriate committee so that they may recommend eligible recipients. Signature of Applicant Date ACADEMIC INFORMATION SECTION NOTE: All students must have this section completed by their college/university registrar and returned with their application. (Please print clearly) I certify that is enrolled for hours for the term, 20, and has a GPA of out of at, and is in (University/College/Trade School). good standing in accordance with current institutional policies. A copy of the student's most recent transcript/semester grades must be included with this application. Signature/Title (Please print clearly) Date Once completed, mail the scholarship application TENNESSEE GAS ASSOCIATION on or before March 31 st to: SCHOLARSHIP FOUNDATION 83 Century Boulevard Nashville, TN 37214 TGA SCHOLARSHIP FOUNDATION USE ONLY Application No: Education History First Enrollment Date: Last Enrollment Date: Last Term GPA: Cumulative GPA: Notified: Accepted: Previous TGA Scholarship Recipient, Year (s),,. 5