2021-22 Scholarship Application
This scholarship application will be valid for students who enroll in the Fall 2021, Spring 2022, and Summer 2022 semesters.
Please only submit a scholarship application once per academic year.
Priority deadline for Northeast Iowa Community College scholarship application is April 1.
Applications will also be reviewed in July and November.
All applicants will be notified of their award status by mail within 30 days of the submission deadline.
Scholarship awards are determined based on your qualifications and how those qualifications may relate to a specific scholarship's criteria as well as the quality of the application's responses. Please review your application before submission by carefully checking the spelling, grammar and quality of content. You may receive assistance at the Writing Center on either campus.
For the most up-to-date listing of scholarships, please visit
Student ID number (can be found in Self-Service on your Unofficial Transcript, Award Letter or on your Student Finance Statement)
Date of Birth. (mm/dd/yyyy)
Address. (City, State, Zip)
Phone Number. (xxx-xxx-xxxx)
Program of Study.
High School attended.
High School graduation date. (mm/yyyy)
Most recent cumulative GPA.
Please check all that apply.
Have financial need
Solely responsible for paying for my education
Received a High School Equivalency Diploma (HSED)
Have a documented disability
Dupaco Community Credit Union member
Family of a Bruening Rock Products employee
Family of a Woodward Communications employee
Family Member employed at Mercy Medical Center
Spouse or child of Veteran
Active-Duty Military member
Spouse or child of Active-Duty Military member
Why are you deserving of this scholarship?
What are your educational goals and how will they help you reach your career goals?
Describe your financial need situation.
Please list all leadership or community activities that you were or are currently involved in? These activities may include extra-curricular, volunteer, clubs and associations and family commitments.
If you have any questions, please contact the Advancement Office.
844.642.2338, ext. 1474
Email us at
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This form was created inside of Northeast Iowa Community College.