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Lewis Appalachian Scholarship Application

The Lewis Appalachian Scholarship is a $1000 non-renewable scholarship awarded to an incoming University of the Cumberlands student.

Please complete all sections of the application. The deadline for submission is February 2, 2015.

Section 1 - Personal Information

Last Name First Name Email Address
Mailing Address, Street, P.O. Box or Rural Route
City State Zip
/ /
Home Phone Cell Phone Date of Birth

UC ID# (Optional)   Beginning semester at University of the cumberlands

Section 2 - Academic Information

Name of High School
out of
GPA High School rank SAT Scores ACT Scores
Anticipated Major(s)  

Section 3 - Activities and Interests

A.  List and briefly describe your high school extracurricular activities (e.g. memberships in organizations, sports, etc.)

Organization Involved Position Held Date of Involvement


Brief description of your responsibilities:


B. List and briefly describe volunteer activities in which you have been involved:


Organization Activity Date of Involvement


Brief description of how you participated:


C.  List honors or academic awards you have received (e.g. scholarly activities, research, etc.):


Award/Honor Institution/Organzation Date


D. List and briefly describe any work experience:

Position Employer Dates of Employment


Brief description of your work responsibilities:

Section 4 – Short Essay


Respond to the essay question below.

 In a well-constructed essay, respond to the following in detail. Your response should be 500-1000 words in length and have a clear thesis.

Describe the area that you grew up in and how it helped shape you into the kind of person you are today.  How will the area you have resided in during most of your life affect your future success and outcomes of achievement? Do you plan to “give back” to your hometown in any way? If so, how?