Test - Couch Oil Company

Name*

First Last

Email*

Phone*

Address*

Street Address Address Line 2 City State ZIP Code

County of Residence*

Date of Birth*

Year of High School Graduation?*

Name of High School*

Weighted GPA (9-12)*

Intended College/Community College*

Intended Major*

Intended Minor (if applicable)

How Did You Hear About this Scholarship?*

Parent/ Guardian #1*

First Last

Phone*

Email*

Parent/Guardian #2 (if applicable)

First Last

Phone

Email

Essay Question #1*

Upload a document describing
a) The benefits of a college education in relation to your future goals.
b) Why you believe you are deserving of this scholarship. File types accepted: pdf, doc, or docx.

Accepted file types: pdf, doc, docx, Max. file size: 50 MB.

Essay Question #2*

Upload a document sharing some personal information about yourself. You may include, but are not limited to, the following:
a) What makes you unique?
b) Life events or activities that have shaped you as a person.
File types accepted: pdf, doc, or docx.

Accepted file types: pdf, doc, docx, Max. file size: 50 MB.

Resume of Honors, Achievements and Extracurricular Activities*

Please upload resume of significant honors, achievements and extracurricular activities in grades 9-12, including leadership experience.
File types accepted: pdf, doc, or docx.

Drop files here or

Accepted file types: pdf, doc, docx, Max. file size: 50 MB.

A Letter of Recommendation

Please upload one letter of recommendation from a high school teacher/counselor/advisor (high school graduates must submit one letter from an employer or community leader). Please note - If your recommender prefers to send this separately, please request this document to be emailed to [email protected]
File types accepted: pdf, doc, or docx.

Accepted file types: pdf, doc, docx, Max. file size: 50 MB.

Supporting Documents

Please upload any other supporting documents or letters that may enhance your application.
File types accepted: pdf, jpeg, png, doc, or docx

Drop files here or

Accepted file types: pdf, jpeg, png, doc, docx, Max. file size: 50 MB, Max. files: 15.

High School Transcript

Please upload your high school transcript from grades 9-12 here. Please note - If your school does not allow you to have access to your own transcripts, please request them to be sent to [email protected]
File types accepted: pdf, doc, or docx

Drop files here or

Accepted file types: pdf, doc, docx, Max. file size: 50 MB, Max. files: 12.

Acceptance Letter*

Please upload one letter of acceptance to your intended college/community college.
File types accepted: pdf, jpg, or png

Drop files here or

Accepted file types: pdf, jpg, png, Max. file size: 50 MB, Max. files: 5.

Consent*

I agree to the following:

By submitting this application, you grant Couch Oil Company and the Durham Bulls Baseball Club permission to use your image in print and/or digital media.

By submitting this form, you are consenting to our privacy policy.