Eligible students must reside in a qualifying Golden LEAF County. You must have JavaScript enabled to use this form. Current Personal Information Educational Information Other Information Applicant Certification Complete Required fields are marked with an asterisk '*'. Student Full Name * First * Middle * Last * Student Email * Student ID * Phone * Address * Address * City/Town * State/Province * - Select - Alabama Alaska American Samoa Arizona Arkansas Armed Forces (Canada, Europe, Africa, or Middle East) Armed Forces Americas Armed Forces Pacific California Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming ZIP/Postal Code * NC County of residence * More Info (To be eligible for an initial scholarship award, your permanent residence must be a qualifying Golden LEAF County) Length of residence in county * - Select - 1 year or less at least 5 years more than 5 years Citizenship Status (Select one) * U.S. Citizen/National Eligible Noncitizen (Alien Registration Number/ A-Number required below) Neither U.S. citizen nor eligible non-citizen Eligible noncitizens must enter A-number: Eligibility Statement: Applicants must be a U.S. citizen, a U.S. national, or an eligible non-citizen to qualify for the Golden LEAF Community Colleges Scholarship. Applicants selecting 'Neither U.S. citizen nor eligible non-citizen' are not eligible for award consideration.