Caryl Lees Real Estate

Scholarship Application

due date: march 18, 2005

FOR SCHOLARSHIP OFFICE  USE ONLY

Academic Year ___2003________

Date Received ________________

GPA ________________________

Units Completed ______________

GENERAL INFORMATION AND INSTRUCTIONS                     

Please type or print neatly in black ink only!.                    

All students’ scholarship application forms will be given full consideration for each scholarship for which they are eligible.  Scholarships are awarded based on sponsor criteria, academic achievement, personal qualifications, and financial need.  It is essential that all sections of this application be completed accurately.

 

BIOGRAPHICAL INFORMATION:

Name:   SSN: --    

                  Last                              First                          Middle

Address:   Birthday: //

                 Street              City              State              Zip                                                                        M M  / D  D / Y Y

Phone:( ) - Marital Status: SingleMarried. No. of children:

Are you a U.S Citizen or Permanent Resident? Yes No.

EDUCATION: Current Enrollment Status:   Cuyamaca College

Major: Units Enrolled: Units Completed:

WHAT semester do you expected Graduation Fall  Spring and year . Do you plan to transfer to a 4-year 

University?    Yes  No, if so WHERE will you transfer to:   

and WHAT semester and year do you expect to start Fall Spring and year 

Other Colleges Attended (1)       Units:  

Other Colleges Attended (2)       Units:

RE-ENTRY STUDENTS INFORMATION: Are you a high school graduate? Yes No 

Name/Location of High School:

Last high school/college attended:  Date attended: /

                                                                                                                                                                                                                     M M  /  Y Y

SCHOOL & COMMUNITY ACTIVITIES: (Add additional sheet if necessary)

High School, College, Organization etc . .

Offices, Activities, Awards, or Honors  

   Offices, Activities, Awards, or Honors  

                 

ELIGIBILITY CRITERIA:

Some scholarships have specific criteria.  Please complete the following, which may apply to you;

Parent is a Veteran of WWII, Korea, Vietnam or Desert Storm Veteran (Branch:),  Single Parent   

Active Duty (Branch:)  African American  Asian  Hispanic  Native American   

First-Generation College Student  Other (Specify :)

 


WORK EXPERIENCE:

Show Present or Most Recent Employment First  (Add additional sheet if necessary)

Dates:                                                                                                                   

                                                                             Place of Employment                      Title/Position

From:/ To:/   

From:/ To:/   

REFERENCES:

Please inform us of two references you plan to submit.  (It is advised not to use family members as references)

Faculty/Personal Reference Name                  Department/Title/Position

1.    

2.    

APPLICANT STATEMENT:

This statement is one of the most important aspects of this application and is equivalent to an interview.

Please state the following on a separate sheet of paper and in narrative (essay) form (within 1-2 pages):

q       Educational objectives (Certification, AA, AS, BA.BS, MA etc. . . .)

q       Career goals/plans (Teacher, Engineer, Nurse, Doctor etc.. . .)

q       How you will benefit from scholarship assistance.

q       Any campus, family and community activities/commitments, honors and/or awards received

q       Any other information you want the Scholarship Committee to consider

NOTE:  The Applicant Statement MUST BE TYPED, DOUBLE SPACED and SIGNED.  Your response will be evaluated on content, organization, grammar and mechanics (spelling, punctuation, etc.).

STUDENT FINANCIAL STATEMENT

Have you applied for Financial Aid? Yes No  Are you receiving Financial Aid? Yes  No  

Complete income and expenses for the academic year for which you are applying for assistance:

Estimated Income Available (9 Months)                                Estimated Expenses (9 Months)

Student's Net Earnings $     Tuition & Fees $ 
Spouse's Net Earnings $   Books & Supplies $  
Savings/Checking $  Room & Board $  
Parental Assistance $  Transportation $ 
Nontaxable Income $  Clothing $  
Other Income (Specify) $  UninsuredMed/Dent $  
Miscellaneious $  

Total

$   

 Total $  
 

CERTIFICATION and AUTHORIZATION

All the information on this form is true and complete to the best of my knowledge.  I hereby authorize the release of my scholarship application, references and transcript information to any organization or individual involved in the selection of scholarship recipient.  In the event that I am chosen to receive an award, I authorize the scholarship sponsor and/or Grossmont-Cuyamaca Community College District to release/publicize my name, the name of the scholarship, and the amount of the award.  
 
 

 

 

 

 

                                                                          

 //

     Signature of Student


  

SCHOLARSHIP REFERENCE

STUDENT INSTRUCTIONS: Please type or print in black ink the following information and give to the person you are requesting a reference.  This reference must be included in your Application Packet. 

Name:  SSN: --

            (Please Print)      Last                        First                 Middle

Address:

Street                              City              State                Zip                                           

Declared Major:  Date Submitted:  // 

ATTENTION STUDENT:  DO NOT WRITE BELOW THIS LINE

______________________________________________________________________________

REFERENCE INSTRUCTIONS:

The student named above has listed you as a reference on a scholarship application.  Please complete the following information and return this form to the student to be included in the application packet.  You may include a letter of reference on letterhead.  If attaching a letter, please direct your letter to "Dear Scholarship Committee".  This information is for use only by committees reviewing application for scholarships, awards, and/or grants.  Thank you for your assistance.

q     How long have you known this student?  In what capacity?

q     Are you aware of any financial need for this student? Yes No  

q     Do you have knowledge of any pertinent information you feel will assist the selection committee in evaluating this student for the scholarship they are applying?  Yes No      

q     Do you have knowledge of any pertinent information regarding this student's academic and personal achievements, academic status, ranking among peers, as well as his/her potential for future success?  

       Yes No

q     If you have answered "Yes" to any of the above questions, please use the back of this form to submit your response or you may use a separate sheet. 

q     Keeping in mind the student's capability for completing studies in the stated major, please rate the student on the following:

Applicant's Characteristics

 Unk. Exc. Good Fair Poor
Ability to Learn
Analytical Ability (Judgment)
Communication Skills
 Integrity
 Maturity/Cooperation
Leadership

Completed By:_____________________________       /

                      References Signature                         Name & Title/Position                                                                                                            

SCHOLARSHIP REFERENCE

Please use the space below for any additional comments.  Include any pertinent information you feel will assist the selection committee in evaluating this student eligibility and/or need.  Please sign your name at the end of your statement.  Thank you for your assistance.  

___________________________________________

Completed By:_____________________________       /

                      References Signature                         Name & Title/Position          


  

SCHOLARSHIP REFERENCE

STUDENT INSTRUCTIONS: Please type or print in black ink the following information and give to the person you are requesting a reference.  This reference must be included in your Application Packet. 

Name:  SSN: --

            (Please Print)      Last                        First                 Middle

Address:

Street                              City              State                Zip                                           

Declared Major:  Date Submitted:  //  

ATTENTION STUDENT:  DO NOT WRITE BELOW THIS LINE

______________________________________________________________________________

REFERENCE INSTRUCTIONS:

The student named above has listed you as a reference on a scholarship application.  Please complete the following information and return this form to the student to be included in the application packet.  You may include a letter of reference on letterhead.  If attaching a letter, please direct your letter to "Dear Scholarship Committee".  This information is for use only by committees reviewing application for scholarships, awards, and/or grants.  Thank you for your assistance.

q     How long have you known this student?  In what capacity?

q     Are you aware of any financial need for this student?