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Lake Land College Foundation
Faculty Association Scholarship Application for Fall/Spring 2013-2014
Date Due: April 1, 2013


To be eligible for consideration:





Full Name: Student ID:  
 
Street:
City: State: Zip:
Phone: Email:  
 
Age: Marital Status: No. of Children:
High School Attended: Graduation Year:  
 
Classification at LLC: Program of Study:  
 

I hereby authorize the office of Admissions and Records and the Financial Aid Office at Lake Land College to release information from my permanent student records and financial aid records to the individual(s) responsible for the screening or selection of the above-named scholarship. I understand that all information is held in confidence.


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