Fillable William and L.R. Gale Community Foundation a/k/a Galeton (C&N)

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William and L.R. Gale Community Foundation a/k/a Galeton (C&N)

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Page 1 of 5
William and L.R. Gale Community Foundation
a/k/a Galeton Foundation
Scholarship Application
C&N WEALTH MANAGEMENT, TRUSTEE
P. O. BOX 58
WELLSBORO, PA 16901
Telephone: 800-487-8784 or 570-724-0243
SCHOLARSHIP INFORMATION
Selection of candidates and the amount and duration of awards will be made by
the Galeton Foundation Administrative Committee in amounts to be determined
by them contingent on available funds. Available funds will be determined
annually based on a formula submitted to the Internal Revenue Service (available
upon request).
APPLICANTS MUST MEET THE FOLLOWING REQUIREMENTS:
1. Be a current high school senior attending Galeton Area High School
accepted to an accredited college, university or trade school.
2. Have a cumulative grade point average of at least 2.0.
3. Student and parent(s)/guardian(s) must be residents of the Galeton Area
School District for at least one full school calendar year prior to application
for scholarship. If a scholarship is awarded to a student, that student and
his/her parent(s)/guardian(s) must remain residents of the Galeton Area
School District for the duration of the scholarship.
SCHOLARSHIP GUIDELINES
The scholarship award may be used to help pay for tuition, books, and room and
board charges. Disbursements from the Foundation are made directly to the
university, college or trade school. Students will be required to provide copies of
tuition statements and academic transcripts reflecting a satisfactory academic
standing of 2.8 or higher for each semester to the Trustee.
Page 2 of 5
Application Instructions
STUDENT APPLICANT:
A. Complete the Application and return to the address below by April 15
th
of
the current year.
B. Include a copy of the letter of acceptance from the college you will attend
and a copy of your high school transcript.
Galeton Foundation
C&N Wealth Management, Trustee
P. O. Box 58
Wellsboro, PA 16901
Fill-in applications are available on-line on the C&N Wealth Management
website at cnbankpa.com/Personal/Invest/Scholarships & Grants/
Galeton Foundation Scholarship Information and Application.
If you have any questions, please contact your guidance office or
C&N Wealth Management at 1-800-487-8784.
Page 3 of 5
William and L. R. Gale Community Foundation
a/k/a Galeton Foundation
P
lease type or print in ink
PERSONAL DATA
NAME: ___________________________________________________
ADDRESS: _________________________________________________
CITY: ________________ STATE: _______________ ZIP: __________
TELEPHONE: _________________ DATE OF BIRTH: ____________
FATHER’S NAME:____________________________________________
EMPLOYER: _____________
MOTHER’S NAME:____________________________________________
EMPLOYER: _______________
E-MAIL ADDRESS: _____________________________________
COLLEGE AND CAREER GOALS
NAME OF THE COLLEGE YOU PLAN TO ATTEND: _____________________
WHAT MAJOR WILL YOU PURSUE: _________________________________
WHAT DEGREE DO YOU EXPECT TO RECEIVE: ______________________
Page 4 of 5
WHAT ARE YOUR PLANS AFTER RECEIVING YOUR DEGREE:___________
________________________________________________________________
________________________________________________________________
WHAT OTHER SCHOLARSHIP (S) HAVE YOU APPLIED FOR: ____________
________________________________________________________________
EMPLOYMENT (During high school years only)
Employer Type of Work Hours Dates of Employment
Per Week From: To:
_____________________ _____________ _________ __________________
_____________________ _____________ _________ __________________
_____________________ _____________ _________ __________________
Do you plan to work part time during the college year? ____________________
Do you plan to work during the summer? _______________________________
What type of work are you interested in? _______________________________
________________________________________________________________
DESCRIBE IN DETAIL HOW YOUR ANTICIPATED DEGREE WILL BE USED IN
THE GALETON AND SURROUNDING AREA.
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
Page 5 of 5
________________________________________________________________
COLLEGE COSTS FOR YOUR FRESHMAN YEAR (Do not include personal
expenses)
Tuition and Fees: _________________________________________________
Room and Board: ________________________________________________
Books and Supplies: _______________________________________________
AMOUNT OF SCHOLARSHIP YOU ARE REQUESTING:
________________________________________________________________
Date:
Applicant’s Signature
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William and L.R. Gale Community Foundation aka Galeton (C&N)

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Completed 10 August 2021

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