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Cheatham-White Scholarship Self-Nomination Form


Nominations must be received no later than November 1 of the student's senior year and meet one or both of the following conditions:
  1. Home schooled or not attending an endorsing school
  2. Did not receive a school endorsement, but still feel highly qualified for consideration.

Upon submission of this form the person listed as a reference will receive an email notification to complete a brief recommendation on the applicants behalf. Once the recommendation form has been received, applicants will receive a notification of nomination for the Cheatham-White Scholarship. The applicant will be provided detailed instructions regarding the application process.

Students are unable to complete an application for the Cheatham-White Scholarship until the Self Nomination and Reference Forms have been submitted and received. Students must have applied for admission to North Carolina Central University and be admitted to be considered for the Cheatham-White Scholarship.


A completed application must be received on or before December 15 for consideration of this scholarship.
This Nomination Form will be available until 11/1/2018 11:59 PM.

For More Info: University Scholars Program at 919-530-6520 or scholars@nccu.edu.

* = Required Field  

Student Nominee Information

First Name *
Middle Init.
Last Name *
E-Mail *
Street Address *
City *
State *
Zip Code *
Telephone *
Residence Status *  

Academic Information

High School *
City *
State *
Cumulative GPA on a 4.0 Scale *
Class Rank
If your school does not participate in Class Rank, please leave blank.
Size of Senior Class
Top Percentage  
Briefly describe what distinguishes you from other students? *


Please provide the name and contact information for someone to support your self-nomination.
This person will receive a separate email to submit requested information. Recommendation cannot be a relative.

Recommender Name *
Relationship To Student *
Recommender Email *
Recommender Phone *

Self Endorsement

To be completed and signed by the student nominee.
I acknowledge my endorsement and consideration for the Cheatham-White Scholarship based upon my outstanding academic achievement, stellar character, intellectual promise, leadership, and service commitment. I also certify that the submission of information above is accurate and describes my record to the best of my knowledge.

Your Full Name
Departmental Contact: Associate Director of University Scholars, Christina Garrett
Or, contact the NCCU ITS Helpdesk: helpdesk.nccu.edu or call 919-530-7676.
NCCU complies with Title IX of the Education Amendments of 1972, which prohibits discrimination on the basis of sex in all programs and activities (including sexual harassment and sexual violence) in the University's educational programs and activities. For additional resources or to file a Title IX complaint, visit the NCCU's Title IX webpage.
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