Scholarship Application for Leadership North Carolina Class XXVII

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Leadership North Carolina ScholarshipsA limited number of need-based scholarships are available through the William Garrett Fund and the BCBSNC 100County Initiative Scholarship. All scholarship applicants must be accepted into the LNC program on the merits of theirapplications before they will be considered for scholarship funding. Scholarship funding decisions are separate fromprogram application review, and applying for a scholarship will not affect consideration of your program application.

William Garrett Fund ScholarshipsThe William Garrett Fund provides need-based scholarships to help candidates from across the state for whom theprogram fee presents a barrier to participation. Most Garrett Fund scholarships fall between $500 and $2,000. LNCmay not be able to provide the full amount requested but will work diligently with you to support your participation andto create an affordable payment plan.

BCBSNC 100 County Initiative ScholarshipsThrough a generous grant from Blue Cross and Blue Shield North Carolina, LNC is able to provide additional supportto applicants from counties that have never been represented or have been underrepresented in participation in theLNC program. This scholarship covers $4,750 of the $5,500 program fee as well as hotel accommodations for theprogram year.

The 9 counties that have never had a participant in the program are: Alexander, Cherokee, Gates, Greene, Hoke,Martin, Northampton, Tyrrell, and Yadkin. If you live and/or work in one of these counties or in another Tier Onecounty, please indicate this as you complete your scholarship application. Priority consideration for the BCBSNC 100County Initiative Scholarships will go to candidates from the 9 counties listed above.

Application InstructionsPlease complete all elements of the scholarship application by June 28, 2019. This application should be completedfollowing the submission of your Class XXVII program application. You may save your scholarship application inprogress and return to it at any time before your final submission. If you have any questions, please contact Kelly Turner, LNC program director, at kelly@leadershipnc.org or (919)

For reference only. Application must be completed online May 20 - June 28, 2019. www.leadershipnc.org.

803-5325.

Confidential Class XXVII Scholarship Application

Personal Data

First *

Middle

Last *

Preferred Email *

Annual Household Income

Please select your annual household income. *

Installment Payment Option

The option of an installment payment plan is offered, with payments made in three installments--twopayments of $1,835 and one payment of $1,830. Installment payments are due on or before September 1,2019; October 1, 2019; and November 1, 2019. Would this payment schedule eliminate your need forfinancial assistance? *

Program Fee Contributions and Scholarship Request

Employer Contribution *

Personal Contribution *

Other Private Sources *

Subtotal *

Scholarship Request *

Please select...

Please select...

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For reference only. Application must be completed online May 20 - June 28, 2019. www.leadershipnc.org.

Total *

Consideration for BCBSNC 100 County Initiative Scholarship Support

If you live and/or work in one of the following 9 counties or in another Tier One county, please list your countybelow. Connection to one of these counties does not guarantee acceptance into the program or financial support. Applicants from the 9 never-represented counties receive first priority for funding. Those counties are: Alexander,Cherokee, Gates, Greene, Hoke, Martin, Northampton, Tyrrell, and Yadkin.

Narrative

Describe any factors that should be taken into consideration as your request is reviewed.

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For reference only. Application must be completed online May 20 - June 28, 2019. www.leadershipnc.org.