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Future Connect Application

If you meet the eligibility requirements for the Future Connect program and would like to apply, please fill out the form below. This is a secure form to ensure the safety of your personal information. There are 4 essays to complete near the end. The average time it takes to complete this application is 30 minutes. This application will not be saved if closed. Please be prepared to complete the entire application then click submit when finished.

1. Student Identity Information
2. Student Contact Information
3. Student Demographic Information
Gender:
 Race/Ethnicity:
4. High School Information
5. Program Participation
In a Summer Youth Connect program? Did you participate in a Summer Youth Connect program (Ninth Grade Counts, Career and College connections, SummerWorks)?
What SummerWorks or Summer Youth Connect program(s) have you participated in? Please check all that apply. NOTE: We will verify your program participation to help determine your scholarship eligibility.
6. Career & College Plans
Intended Enrollment for fall 2014: Do you intend to enroll at PCC for fall classes, 2014? If you do not attend PCC in fall 2014 then you will not be eligible for this scholarship.
Enrollment Status: The amount of classes you are enrolled in will not affect your scholarship eligibility.
7. Personal Information
Father's Schooling History Has your father completed a college degree (A.A. or B.A./B.S.)?
Mother's Schooling History Has your mother completed a college degree (A.A. or B.A./B.S.)?
Household Information Does anyone in your household currently receive any of the following? Please check all that apply:
Living Situation Do any of the following describe your living situation? Please check all that apply:
Estimated Family Income Please give an estimation of your family's annual income.
Have you completed a Financial Aid Application (FAFSA) for 2014-2015 school year? Please note this is NOT mandatory to be accepted for this scholarship.
Did you select PCC as the school choice on this application?
8. Essay Questions
9. Certification and Agreement

This certification takes the place of a signature. By answering "Yes" to each of the questions below, you certify that you have read, understood, and agree to the following certification statements.