OLHCC Scholarship Application

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	Last Name (required)

	First name

	Middle Initial

	Street Address

	Apt.

	City

	State

	Zip Code

	Home Phone

	Cell Phone

	Year By Hours

	Your E-mail

	Intended Major

	Grade Point Average (GPA)

	ACT Score (if applicable)

	Date of Birth

	Extracurricular Activities

	Honors/Awards

	Community Service

	Leadership Positions

	Previous Institutions/High Schools