Quarterly Youth Account
Scholarship Form
Name:
Account #:
New Youth Account
Existing account with $25 deposit
Congratulations! You are now eligible for a $1,000 scholarship. This form must be filled out and
turned in by the last day of the quarter to be eligible*. This form must be signed by the member
support representative that opened the new Youth Account, or the teller that accepted the $25
deposit. Good luck!
Signature
Date
Staff Signature
*Application deadlines are as follows: June 30th for quarters 1 and 2, September 30th for quarter 3 and December 31st for quarter 4. Main
account holder must be under the age of 18 in order to qualify. One entry per member. Only new accounts or accounts with a $25
dollar deposit during the quarterly qualification periods will be accepted. Attendance is not required at the drawing to win. A member
cannot win the Quarterly Youth Scholarship twice.
**For Office Use: Scan then forward to Marketing
Quarterly Youth Account
Scholarship Form
Name:
Account #:
New Youth Account
Existing account with $25 deposit
Congratulations! You are now eligible for a $1,000 scholarship. This form must be filled out and
turned in by the last day of the quarter to be eligible*. This form must be signed by the member
support representative that opened the new Youth Account, or the teller that accepted the $25
deposit. Good luck!
Signature
Date
Staff Signature
*Application deadlines are as follows: June 30th for quarters 1 and 2, September 30th for quarter 3 and December 31st for quarter 4. Main
account holder must be under the age of 18 in order to qualify. One entry per member. Only new accounts or accounts with a $25
dollar deposit during the quarterly qualification periods will be accepted. Attendance is not required at the drawing to win. A member
cannot win the Quarterly Youth Scholarship twice.
**For Office Use: Scan then forward to Marketing