Dollars for Scholars Scholarship Application |
1) Personal Info: Student Name: ________________________________________________________________
Address: ________________________________________________________________
Email Address & Phone Number: ________________________________________________________________
Parent (or Guardian) Name(s): ________________________________________________________________
2) Eligibility Information: (check one) (see http://www.oocities.org/hhsdfs/Eligibility.rtf for full info)
__ CSF Member (or eligible): ___ Life Member ___ CSF Member for at least 3 semesters
__ Not a member of CSF, or eligible less than three semesters (attach teacher recommendation (required))
__ Other eligibility: __ Art scholarship __ Other: ________________________________
3) College Intentions: (indicate at least one, attach additional page if necessary)
__
__
__ UC San Diego (UCSD) * __ Other UC or private college: * ________________________
Preferred
consideration will be given to planned attendees of
Collegiate Partner colleges (see http://www.californiadollarsforscholars.org/partners.htm)
Attach copy of acceptance letter(s) from indicated college(s).
4) Academic Information:
GPA–Unweighted/Weighted: _____/_____ Test Scores - SAT (Verbal/Math): _____/_____ ACT: _____
5) Other scholarships that I know that I will be receiving (name and amount of each, and total):
_______________________________________________________________________________________________
_______________________________________________________________________________________________
6) Why should HHSDFS give you a scholarship (briefly)?: _____________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
7) Writing sample – “Thank You Letter”
All the funds for the scholarship(s) that will be awarded this year came from donations from individuals and businesses who wanted to help young people attend college and achieve their long-term personal potential. All funds were raised by efforts of parent, student, and counselor volunteers.
If you had the opportunity to express your appreciation to the person(s) and/or organization(s) whose donations made your scholarship possible, what would you like to say to them?
IMPORTANT: Write your statement in the form of a letter (typewritten preferred) on a separate sheet.
8) Applicant statement (signature required):
I am a graduating senior at
I understand that publicity is a key ingredient in raising community awareness of Dollars for Scholars and raising funds for scholarships, and that community awareness of the student(s) receiving scholarships is important. Therefore, if awarded a scholarship, I agree to provide a photograph of myself. I also agree to public disclosure of my First Name, Last Name, HHS graduation year, and intended College. I also consent to release of my statement of appreciation to donors who made my scholarship possible. I also agree to consider possible interviews from newspaper or other media, or other publicity as notified by HHSDFS (i.e. not required).
_____________________________ Date: __________ _____________________________ Date: __________
Student
Parent / Guardian