Departmental Grants
Student Application
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are you a resident of North Carolina?
Yes
No
Which workforce continuing education program are you enrolled in or interested in?
What is your enrollment status?
Please Select
Already enrolled
Planning to enroll
Employment Status:
Please Select
Full Time
Part Time
Unemployed
Retired
Other
Are you willing to participate in Employability Skills Training?
Please Select
Yes
No
Please briefly describe why you need scholarship funding:
Submit
Should be Empty: