Mason County Promise Zone Scholarship Renewal Application
This application is intended for those who are already utilizing the Mason County Promise Scholarship Dollars. This application will help us confirm all of your contact information and that you have maintained eligibility for the Promise Scholarship.
Consent Terms and Electronic Release:
I hereby authorize any school that I am enrolled in that participates in the Promise Zone Scholarship, through its agents and employees, to release any of my financial aid, attendance, demographic and/or academic record information, in whole or in part, to my local Promise Zone Authority/Organization coordinator, or his/her designee, to facilitate the analysis of my scholarship eligibility and the subsequent educational and economic impact of this scholarship.
As a recipient of a Promise Zone educational scholarship, that award information becomes part of my educational record. By consenting to receive any scholarship amount awarded to me, I agree to allow the release of this information in my educational record to third parties specified under the Family Educational Rights and Privacy Act (FERPA). FERPA affords certain rights to students concerning the privacy of, and access to, their education records. While this form authorizes my school, in conjunction with the local Promise Zone Authority/Organization, to release educational records to third parties, it does not obligate either entity to do so. My school reserves the right to review and respond to requests for release of my educational record on a case-by-case basis. For additional information, I can visit the U.S. Department of Education’s website at
www.ed.gov/policy/gen/guid/fpco/ferpa/index.html
.
The Promise Zone Scholarship can have several positive impacts on postsecondary enrollment, persistence, degree attainment and overall success in college. To understand these impacts, I authorize my postsecondary academic record information, in whole or in part, to be released back to my local Promise Zone Authority/Organization coordinator, or his/her designee, in adherence to FERPA for analysis to inform and improve the Promise Zone Scholarship program.
I also authorize my local Promise Zone Authority/Organization to use information regarding my scholarship in promotion of the Promise Zone Scholarship. The Mason County Promise Zone, and its entities, may be authorized to use my portrait, picture, photograph, name, voice and/or image on videotape, audiotape or film, or any other reproduction of me and to distribute and/or exchange copies of these to promote the program and the public schools of Mason County. No compensation is offered in exchange for permission.
This release is authorized starting on the date of the electronic signature on this agreement and after scholarship receipt for statistical purposes. To rescind this Authorization, I understand that I must submit a written notification of rescission to my school. I will also notify my local Promise Zone Authority/Organization in writing of my decision to rescind my authorization. This rescission would result in the termination of my receipt of the scholarship.
My signature (or that of my parent/guardian if I am under the age of 18) electronically via date stamp indicates that I have read this Authorization to Release Educational Records form and that I authorize the release of educational records as described above.
* Required
Required Certifications
I certify that all information submitted in this application is accurate and true.
Yes
I agree to the acceptance terms of the Mason County Promise Scholarship Application.
Yes
I authorize the release of my educational records as required by the terms of the scholarship.
Yes
Book and materials are not currently covered by Promise funds. Students should plan for book and course material costs to be a personal investment.
Yes
Students will have a maximum of four years from the date of high school graduation, or from the date of issuance of a GED or its equivalent, to use Promise scholarship monies
Yes
Promise funds may be used to cover a maximum of 72 attempted credits, the equivalent to an Associate’s degree from West Shore Community College
Yes
Students must apply annually and remain eligible for federal aid under West Shore Community College's Student Academic Policy in or to remain eligible for the Promise
Yes
Students must enroll in a minimum of nine (9) credit hours per fall and winter semester
Yes
Students are eligible to use Promise to cover summer courses
Yes
Consent and Signature
Release and Consent: In addition to receiving and understanding the above information on terms, I also provide consent for all releases and statements above.
I consent
Electronic Signature via Date Stamp
Enter your electronic signature below: Please type your full name below (If an applicant is under the age of 18, please enter parent or guardian's name).
Student
Information
First Name
Middle Name
Last Name
Street
City
State/Province
Zip/Postal Code
Personal Email (used in original Promise application)
Primary Phone
Primary Phone Number Type
Mobile
Home
Other
Birthdate
School Information
Have you completed the Free Application for Federal Student Aid (FAFSA)?
*
Yes
No. As a reminder, to be eligible for the Promise Scholarship FAFSA must be completed.
Current GPA at West Shore Community College
What academic year are you renewing the Promise Scholarship for?
2023-2024
2024-2025
By the end of the current academic year, how many total credits did you attempt? (Between the time you graduated from high school and your most recent completed semester--this info is on your transcript)
Please acknowledge that you understand that you must send a copy of your unofficial transcript upon the posting of your final grades to the Promise Coordinator at info@masoncountypromise.org at the end of each academic year.
I acknowledge this and will send in my transcript when my grades have posted for this academic year. I understand that if I do not submit my official transcript, my scholarship may not be renewed.
I have questions about this and will reach out to the Promise coordinator before next academic year to resolve them.
Optional Questions
Thank you for renewing your application. We have a few additional questions that are not mandatory but could help us get to know you more and serve students better. Please consider answering if possible.
If you participated in Success Coaching this Fall or Winter, what could make Success Coaching at WSCC (through the Promise/WSCC) most helpful in the future? If you didn't participate, please share what would make you more likely to participate in Success Coaching?
What are your plans for the Promise Scholarship, and beyond?
Do you have any thoughts or feedback you would like to share with us?
Is there anything more the Mason County Promise or West Shore Community College could be doing to support your success?
Thank you for your renewal! Please be sure to click submit and send your transcript to info@masoncountypromise!
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Contact Information