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Hack-Miller Pike County Education Trust Scholarship - Farmers State Bank, Trustee

The Hack-Miller Pike County Education Trust Scholarship was established under the William Hack and Elizabeth Miller Family Educational Trust and is available to Pike County, Illinois, graduating seniors. Applicants can pursue any field of study. Recipient will be selected by the Hack-Miller Pike County Educational Trust Advisory Committee based on community service, leadership, character, academic achievement, job experience, and financial need.

Please note you will need the following items available to complete this application, as you will not be able to save and return to the document.

Anticipated cost of first year’s tuition, room & board and books
Copy of High School Transcript

Personal Information

Name (First, Middle, Last)

Telephone Number

Home Address

Email Address

City, State, Zip

County

Length of residence in this county (years)

Name of Parent or Guardian

Address

City, State, Zip

Date and Place of Birth

College Information

Name of college you are planning to attend or are currently attending

Location of College

Anticipated cost of the first year's tuition, room & board and books

Financial Need Information

I confirm that I am in financial need for this scholarship

Check any of the applicable items below to indicate how you plan to pay your expenses not covered by the scholarship:

Money furnished by family

Earnings during the summer

Student Employment

Student Loans

Other means

Please list other means

Are you aware of other monetary awards you are receiving?

Please list other assistance received such as scholarships, etc.

High School Activities and Community Activities

Please list below high school activities and community services such as organizations or projects served and leadership positions held

Special Awards and Honors

Please list below any special honors or awards received in high school or in the community while in high school.

Essay

Please write below a short essay describing your future academic or career plans, course of study/major, including your reason for selecting this field of study

Transcript

Please upload High School transcript or have guidance office send transcript to trust@farmersstate.com (PDF files please)

Acknowledgment

I certify that, to the best of my knowledge, all information given on this application is true and correct.

Date

Signature (please type name)

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