Coast Guard Foundation Scholarship Application Uscg Cg6054
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U.S. DEPARTMENT OF
Coast Guard Foundation
HOMELAND SECURITY
U.S. COAST GUARD
Scholarship Application
CG-1112
CG-6054 (12-05)
APPLICANT DATA:
.
Ms
Mr.
Last Name:
First Name:
MI:
Street Address:
City:
State:
Zip Code:
/
/
/ / /
DOB: Month
Day
Year
Student Tel #:
Sponsor Tel #:
Student E-mail:
High School Data: Will you graduate from high school this year? Yes
No
/
/ / /
Expected high school graduation date: Month
Year
Cumulative GPA:
(convert on a 4.0 basis)
Rank in Class:
of
High School:
City:
State:
College Data:
Did you attend college last year? Yes
No
If yes, give your GPA
(convert on a 4.0 basis)
List the undergraduate US college/school you attend or the colleges/schools where you have applied.
Name:
State:
Name:
State:
Major:
/
/ / /
Expected college graduation date:
Month
Year
Expected college degree: AA
BA
BS
Other
If other, please explain:
Community Service and Extra-Curricular Activities Data:
Please provide information that relates to activities occurring during the last 4 years of high school to the present. You may
attach a resume highlighting your service or activities.
U.S. DEPT. OF HOMELAND SECURITY, USCG, CG-6054 (Rev. 12-05)
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