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SPC Open Doors Scholarship Application 2023-2024 (NC)

Thank you for your interest in this scholarship. We are reaching the end of our available funding.

You may continue to fill out the application so your information can be kept on a waiting list in case scholarship funds become available.

 

To be considered for the scholarship, you must:

Complete this form to continue with the scholarship award process. If you are not sure how to respond to any question, select "n/a". 

 

Please enter the following information about yourself.
Which training program are you pursuing?
If you are already an SPC student, what is your Student ID number?
Phone
Email

Street Address

NOTE: A form of identification to establish Florida residency will be required in the Non-Credit Program Survey.  The identification you provide must match the address in this application and the address you provide to register for the SPC Program. Failure to provide matching address information may delay or hinder you from receiving the scholarship.

City
State
Zip Code
Date of Birth
/ /
Please select your gender (optional)
Please select your ethnicity (optional)
I am a resident of Florida and have lived in the State a minimum of 12 months.
Florida Driver's License or ID Number

To establish Florida residency, one of the following forms of identification must match the address for your Open-Door Scholarship application and SPC registration for the program. Failure to provide this information may hinder you from receiving the scholarship.

Please Upload a JPG or other file type that includes a copy of one of the documents indicated below.

• Notarized proof of residency letter
• Mortgage statement or contract
• Authorized change of address form
• Lease agreement for your residence
• Residence permit
• Residential property deed
• Home insurance or car policy
• Tax forms from the federal or state government
• Driver’s license
• State ID card
• Car Registration
• Letter issued by a public authority (e.g., a courthouse)
• Water Bill
• Electricity Bill
• Residential Gas Bill
• Landline Telephone Bill
• Internet Bill
• Cellular Phone Bill
• Trash or Sewer Service Bills
• Other forms

Authorization

By entering my name below, I hereby give permission for St. Petersburg College to obtain and/or disclose my past, present, and future information or records that may be needed for eligibility determination, monitoring and follow-up purposes. This information may include, but shall not be limited to: school records, grade records, attendance records, employment information, medical records, public assistance records, employment information and vocational rehabilitation assessment or evaluation tools. A photocopy/facsimile of this signed consent form may be used to obtain/release information authorized by signature on this form. It is also my understanding that any information obtained by the above organization will be held in strict confidence. I understand that I may revoke this consent at any time by providing a written statement indicating that my consent to the release of information is no longer given to the party(ies) previously granted permission.

 

By entering my name below, I certify all information is true and correct to the best of my knowledge.
If under 18 years of age, it is required to have a parent or legal guardian sign:
 

If you have comments about this survey or questions regarding how to complete this survey, please contact Workforce Programs at workforce@spcollege.edu.

The Board of Trustees of St. Petersburg College affirms its equal opportunity policy in accordance with the provisions of the Florida Educational Equity Act and all other relevant state and federal laws, rules and regulations. The college will not discriminate on the basis of race, color, ethnicity, religion, sex, age, national origin, marital status, pregnancy, sexual orientation, gender identity, genetic information, or against any qualified individual with disabilities in its employment practices or in the admission and treatment of students. Recognizing that sexual harassment constitutes discrimination on the basis of sex and violates this Rule, the college will not tolerate such conduct. Should you experience such behavior, please contact the Equal Access Equal Opportunity Director/Title IX Coordinator at 727-341-3261; by mail at P.O. Box 13489, St. Petersburg, FL 33733-3489; or by email at eaeo_director@spcollege.edu or spctitleix@spcollege.edu.