Last Name *
Required field
Maiden/Other Name
First Name *
Required field
Middle Initial *
Required field
Address *
Required field
City *
Required field
County *
Required field
State *
Required field
ZIP/Postal Code *
Required field
Home Phone
Cell Phone
Email *
Required field
Birthdate (mm/dd/yyyy) *
Required field
High School
High School Graduation Year
If you completed a GED, please identify the following:
GED Average Score
GED Testing Location
Year of GED Graduation
Some scholarships are awarded to students in certain programs.
Program of Study (select only one) *
Accounting Assistant, Diploma
Accounting, A.A.
Administrative Assistant, Diploma
Advanced Emergency Medical Technician, Certificate
Agricultural / Biofuels Process Technology, A.A.S.
Agriculture / Entrepreneurship, A.A.
Art and Design, A.A.
Associate Degree Nursing - Online / Hybrid Completion, A.A.S.
Associate Degree Nursing, A.A.S.
Athletic Coaching, A.A.
Athletic Training, A.A.
Automotive Collision Technology, A.A.S.
Automotive Technology, A.A.S.
Aviation Maintenance Technology, A.A.S.
Aviation Pilot Training, A.A.S.
Avionics Electronic Technician, Diploma
Biology, A.A.
Biology, A.S.
Bioprocess Laboratory Technology, A.A.S.
Business Specialist - Accounting, A.A.S.
Business Specialist - Office Management, A.A.S.
Business, A.A.
Chemistry, A.A.
Chemistry, A.S.
Child Care Technician - Evening / Online, Diploma
Clinical Laboratory Assistant, Diploma
Commercial Driver Training, Certificate
Computer Accounting, Diploma
Computer Networks and Security, A.A.S.
Computer Software Development, A.A.S.
Construction Management, A.A.S.
Construction Technology, A.A.S.
Counseling, A.A.
Criminal Justice, A.A.S.
Criminal Justice, A.A.S.-B.A.
Culinary Arts, A.A.S.
Diesel Power Systems Technology, A.A.S.
Digital Forensics, A.A.S.
Early Childhood Associate, A.A.S.
Education, A.A.
Electrical & Renewable Energy Technology, A.A.S.
Electronic Engineering Technology, A.A.S.
Electronic Technician, Diploma
Emergency Medical Responder, Certificate
Emergency Medical Technician, Certificate
Engineering
English / Literature, A.A.
Entrepreneurship, A.A.
Forestry
General Education Course Requirements (A.A., A.S.)
General Education Course Requirements (A.A.S.)
Geospatial Technology, A.A.S.
Graphic Design, A.A.
Grounds Equipment Technician, Certificate
Health Information Technology, A.A.S.
Health Unit Coordinator, Diploma
Health, A.A.
Health, A.S.
History, A.A.
Industrial Maintenance, Diploma
Industrial Technology Education, A.G.S.
Landscape and Turfgrass Technology, A.A.S.
Laser / Electro-Optics Technology, A.A.S.
Machine Technology, A.A.S.
Mass Media / Journalism, A.A.
Mathematics, A.A.
Mathematics, A.S.
Mechanical Design Technology, A.A.S.
Medical / Insurance Coding, Diploma
Medical Laboratory Technology, A.A.S.
Medical Transcriptionist, Diploma
Microcomputer Specialist, Diploma
Music, A.A.
Natural Resources, A.S.
Occupational Therapy Assistant, A.A.S.
Paramedic Core, Diploma
Paramedic, A.A.S.
Pharmacy Technology, Diploma
Photography, A.A.
Physical Therapist Assistant, A.A.S.
Physics, A.A.
Physics, A.S.
Political Science, A.A.
Practical Nursing - Evening, Diploma
Practical Nursing, Diploma
Pre-Chiropractic, Pre-Dentistry, Pre-Medicine, Pre-Optometry, A.S.
Pre-Law, A.A.
Pre-Mortuary Science, A.S.
Pre-Osteopathy, A.S.
Pre-Pharmacy (One-Year)
Pre-Pharmacy (Two-Year), A.A.
Pre-Pharmacy (Two-Year), A.S.
Pre-Veterinary Medicine, A.S.
Psychology, A.A.
Public Relations / Organizational Communications, A.A.
Radiologic Technology, A.A.S.
Real Estate, A.A.
Robotics / Automation Technology, A.A.S.
Social Marketing and Technical Design, A.A.S.
Social Work, A.A.
Spanish / French, A.A.
Sport and Fitness Management, A.A.
Surgical Technology, Diploma
Sustainable Agriculture and Entrepreneurship, A.A.S.
Theater, A.A.
Therapeutic Massage, Diploma
Undecided, A.A.
Viticulture, Diploma
Welding Technology, Diploma
Please select one item.
Term you began/will begin program *
Fall
Winter
Spring
Summer
Required field
Year you began/will begin program *
Required field
Some scholarships require a student’s financial aid information.Free Application for Federal Student Aid ).
Have you completed the FAFSA form? *
Yes
No
Required field
If you answered “yes” to the above question...
What is your EFC number
The FAFSA form is available at www.fafsa.ed.gov . The IHCC institution code is 008298 for the Ottumwa Campus and 001849 for the Centerville Campus. Note: Educational Opportunity Center (EOC) is available to help you complete this form. Contact (641) 683-5315 for assistance.
While at Indian Hills, I plan to participate in the following IHCC intercollegiate sports *
None
Men's Baseball
Men's Basketball
Men's Cross Country
Men's Golf
Men's Soccer
Women's Cross Country
Women's Soccer
Women's Softball
Women's Volleyball
Required field
Some Indian Hills Foundation scholarships have preferences for people who meet specific criteria. Please review the following items and select “Yes” for each one that applies to you.
enrolling on IHCC Ottumwa Campus *
Yes
No
Required field
enrolling on IHCC Centerville Campus *
Yes
No
Required field
2nd-year student in*
Yes
No
Required field
International Student *
Yes
No
Required field
qualify for full Pell award *
Yes
No
Required field
do NOT qualify for*
Yes
No
Required field
am a single parent *
Yes
No
Required field
been involved in an*
Yes
No
Required field
am a non-traditional-aged student*
Yes
No
Required field
plan to major in some aspect of theatrical arts *
Yes
No
Required field
new graduate of Ottumwa High School and was in high school athletics or held part-time job *
Yes
No
Required field
plan to pursue degree*
Yes
No
Required field
history of doing volunteer work (explain in “Personal Information” section below) *
Yes
No
Required field
parishioner of St. Mary's Catholic Church in Oskaloosa, IA (recommendation from St. Mary's Catholic Church required) *
Yes
No
Required field
2nd-year student in*
Yes
No
Required field
employee or dependent of an employee of Elliott Oil Company *
Yes
No
Required field
faced obstacles in pursuit of education (explain in “Personal Information” section below) *
Yes
No
Required field
plan to pursue career in agricultural engineering or farm administration *
Yes
No
Required field
involved in school/community activities (explain in “Personal Information” section below) *
Yes
No
Required field
dependent of an employee *
Yes
No
Required field
current resident of*
Yes
No
Required field
current resident of Numa, Iowa *
Yes
No
Required field
completed dual-credit courses while attending Albia High School *
Yes
No
Required field
plan to pursue career in law, political science, or criminal justice *
Yes
No
Required field
received 4-H Gold Award, Eagle Scout Award (Boy Scouts), Gold Award (Girl Scouts), or Congressional Award (Bronze or higher) *
Yes
No
Required field
plan to transfer to University of Northern Iowa to complete bachelor's degree in education *
Yes
No
Required field
completed at least one*
Yes
No
Required field
plan to pursue career in engineering, architecture, or drafting *
Yes
No
Required field
plan to have a major*
Yes
No
Required field
completed 30+ credit hours at IHCC *
Yes
No
Required field
completed Liggett Scholarship Application, available through counselor's office at*
Yes
No
Required field
high school graduate*
Yes
No
Required field
graduate of an Iowa*
Yes
No
Required field
graduate of Pekin High School *
Yes
No
Required field
current or past member of a Jefferson County 4-H Club or FFA Chapter and have participated in the Jefferson County Fair *
Yes
No
Required field
graduate of Cardinal High School *
Yes
No
Required field
2nd year student from Davis County and enrolled in Arts and Sciences *
Yes
No
Required field
member or relative of a member of Meridian Credit Union of Ottumwa *
Yes
No
Required field
plan to pursue career in finance, banking, or a business-related field *
Yes
No
Required field
employee or dependent of an employee of MidWestOne*
Yes
No
Required field
plan to pursue career*
Yes
No
Required field
live within ten-statute miles of the intersection of Main and Second Streets in downtown Hedrick, Iowa *
Yes
No
Required field
farming background and from Appanoose, Davis, or*
Yes
No
Required field
enrolled in Machine Tech program and resident of Schuyler County, Missouri or Davis County, Iowa *
Yes
No
Required field
new graduate of Ottumwa High School *
Yes
No
Required field
graduate of Ottumwa High School enrolled in Health Occupations *
Yes
No
Required field
dependent of employee of NOEL Insurance Company *
Yes
No
Required field
high school graduate from*
Yes
No
Required field
high school graduate from*
Yes
No
Required field
a Mason or have a Masonic relationship (explain in “Personal Information” section below) *
Yes
No
Required field
plan to complete a four-year degree *
Yes
No
Required field
active in the blood donor program *
Yes
No
Required field
enrolled at Centerville Campus, *
Yes
No
Required field
graduate of Fairfield High School, majoring in history, government, political science, conservation, or environment, and plan to*
Yes
No
Required field
plan to participate in *
Yes
No
Required field
participated in extra-curricular activities (explain in “Personal Information” section below) *
Yes
No
Required field
plan to major in religion *
Yes
No
Required field
enrolled in the Diesel Power Systems program and live in a rural area *
Yes
No
Required field
annual income below $40,640 and plan to major in business management, accounting, finance, or mathematics *
Yes
No
Required field
new graduate of Ottumwa High School and participated in OHS organized athletics, including manager, filmer, and/or cheerleader *
Yes
No
Required field
enrolled at Centerville Campus and do NOT qualify for "free" financial aid *
Yes
No
Required field
dependent of an employee*
Yes
No
Required field
employee of Winbco Tank*
Yes
No
Required field
first-generation college student *
Yes
No
Required field
Personal Information: Please limit each response to 100 words or less.Note: Any words beyond this limit will be cut when applications are submitted to the scholarship committee.
Identify how a Foundation *
A value is required.
Describe your active participation in community service, leadership,
Share any other information that may be helpful to the selection committee
Publicity Release: Please identify the following about your hometown newspaper
Name of Newspaper *
Required field
City *
Required field
State *
Required field
Please read the following section before submitting the application. ineligible to receive the next term or next year award unless I submit an appeal letter and receive approval for the award to be reinstated. A general letter of reference is to be forwarded to the Indian Hills Foundation at 525 Grandview Ave., Ottumwa, IA 52501 or emailed by the person providing the reference to Becky.Henderson@indianhills.edu . The letter should be written by someone who knows me well (teacher, employer, co-worker, etc.) but is not a relative. The letter must include my name, a brief summary of how the writer knows me, why I am a good candidate for a scholarship, and the name and title of the person submitting the reference.The deadline for first priority consideration is March 15. Applications and materials received after this date and before June 15 will be reviewed at the Scholarship Committee’s next meeting in July. Becky.Henderson@indianhills.edu .Indian Hills Community College provides equal educational and employment opportunities and does not illegally discriminate on the basis of age, race, creed, color, sex, sexual orientation, gender identity, marital status, national origin, religion or disability in its educational programs, activities or its employment and personnel policies. Inquiries or grievances related to this policy may be directed to the Dean of Human Resources/Equity Coordinator, Indian Hills Community College, 525 Grandview Ave., Ottumwa, IA 52501.
