FA-Curriculum Golden Leaf Scholarship Application

2025-26 Golden LEAF Foundation Application
Eligible students must reside in a rural county that is tobacco dependent, or economically distressed, as determined by the Golden LEAF Foundation (click here for a list of approved counties)
Personal Information
Full Name*
Student ID Number
Student Email Address*
example@my.wilsoncc.edu
Phone Number
Address*

Address

Street Address Line 2

CityState / Province

Postal / Zip Code
NC County of residence*
How long have you lived in the county listed *
(To be eligible for an initial award, your permanent residence mut be in a qualifying county determined by Golden LEAF)
Educational Information
Community College you are attending:
Curriculum program in which you are enrolled:
WCE course you are enrolled in:
You must be enrolled in a course that trains toward a credential listed on the Workforce Continuing Education Credentials List. The latest WCE credentials list is available at WCE Credentials List
Other Information
Have members of your immediate family worked for or owned a farming or agricultural related business?*
Have you or members of your immediate family been employed in traditional industries such as furniture, textiles, or tobacco manufacturing?*
Has anyone in your household lost their job in the past two years?*
Has anyone in your household transitioned from a full-time job to a part-time job?*
NOTE: To be eligible for this scholarship, students must demonstrate need. For curriculum students, completion of the Free Application for Federal Student aid (FAFSA) is required.
Applicant Certification

By signing this, I agree that I have read and understand the requirements of this scholarship. I hereby declare that the information provided on this form is complete and correct to the best of my knowledge.
Applicant Signature: Signature* Time
Date

MonthDayYear
Date
Wilson Community College Marketing Release:

By signing below, I give permission for my photograph, video, and/or written statements to be used for marketing purposes by Wilson Community College if awarded this scholarship.
Approval Signature: Signature*:Time
Date

MonthDayYear
Date
Should be Empty:

2025-26 Golden LEAF Foundation Application

Personal Information

Educational Information

Other Information

Applicant Certification

Wilson Community College Marketing Release: