Please complete this in order to be considered for Lakeview scholarships.

You must be registered for Lakeview courses in order to qualify.  Once enrolled, scholarship applications will remain on file for the period of time for which a student maintains enrollment at LCN.  A current Student Aid Report (FAFSA) MUST be on file in the LCN Financial Aid Office each academic year for which you would like to be considered for scholarships.  The information requested is used to determine whether you meet criteria for specific scholarships.  This application and related information may be forwarded to other organizations that grant scholarships to LCN students.  In submitting this, you attest that all information provided is true and correct to the best of your knowledge.  Please be advised that there is no essay or references required with this scholarship application.  Thank you!

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* 1. Please identify yourself.

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* 2. Please provide your home contact information.

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* 3. Please provide your email address.  (LCN email is preferred, if known).

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* 4. Are you a Benton, Vermillion, or Warren County, Indiana Resident?

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* 5. Are you an Iroquois County, Illinois Resident?

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* 6. Are you a Vermilion County, Illinois Resident?

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* 7. How long have you lived in Vermilion County, Illinois (approx. yrs.)?

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* 8. Location of Lakeview Attendance

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* 9. I currently hold the following license/certification:

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* 10. Do you have any previous healthcare experience?

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* 11. Please describe your experience if you answered yes to the previous question.

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* 12. Do you hold a previous bachelor's degree?

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* 13. Do you consider yourself to represent an ethnic minority?

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* 14. Are you a member of Phi Theta Kappa Honor Society?

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* 15. Please describe any community service you have provided within the last year.  If none, please type none in box below.

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* 16. Are you an employee or relative of an employee of the First Midwest Bank in Danville, IL?

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* 17. Are you directly related to a Lakeview graduate?

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* 18. If you are directly related to a Lakeview graduate please provide the following:

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