2012 Scholarship Application

2012 Scholarship Application

Application must be typed or neatly printed in ink and ALL questions answered

A signed and typed essay of 300 words prepared by the applicant

One letter of recommendation is required (signed and dated)

Current High School transcript

Copy of a letter of acceptance to college/university

Parent(s) financial portion of application must be signed and dated

A current wallet size photo

Application must be signed and dated by the student applying for scholarship

All applications must be received by application deadline to qualify

Application Deadline: March 21, 2012

General Information: SCHOLARSHIPS WILL ONLY BE DISBURSED AFTER RECEIPT OF A LETTER OF ACCEPTANCE AND PROOF OF ENROLLMENT FROM THE COLLEGE OF YOUR CHOICE

This scholarship is for Hispanic female high school seniors only. Any Hispanic female student in the graduating class of a Lake County Indiana High School or its related equivalent is eligible for this scholarship.

Financial and academic information and personal and/or community achievements are the criteria by which applicants will be selected. All students must provide a copy of the letter of acceptance, to the college or institution they plan to attend, along with a copy of their most current high school transcripts. One letter of recommendation is required by a non-relative of the student. Please keep a copy of all material submitted for your records since all information submitted will become the property of the Hispanic Women’s Forum.

Recommendation: The recommendation letter should be from a teacher or employer and should include the length oftime the individual has known the student, and provide information related to leadership, work habits, attendance, notable skills and outstanding recognition achieved by the student. These letters should not -exceed a single side of 8-1/2" x 11" white paper and should be dated and signed by the individual providing the recommendation.

Student Essay: the applicant must submit an essay of 300 words or less typed on 8-1/2" x 11" paper, one side only and double spaced. The contents of your essay should cover at least two of the following topics:

Why you want to go to college.

What do you currently perceive to be the most critical needs for the Hispanic community?

Your future career goals.

What do you hope to do for the Hispanic community?

ALL INFORMATION MUST BE COMPLETED AND PROPERLY FILLED OUT TO BE CONSIDERED.

Return completed applications to:

Hispanic Women's Forum of Northwest Indiana

P.O. Box 451, East Chicago, Indiana 46312

For more information, please contact:

Alicia Montalvo 219-923-2636 or Maria Quiroz 219-398-4744

Applicant Name:______Phone (___)____-______

Last MI First

Address:__________

StreetCityST Zip

E-Mail: ______Cell Phone (___)____-______

High School:______GPA:_____ out of _____ Class Rank ______

Intended College:______

Mother’s Employer:______Position:______

Father’s Employer:______Position:______

Student’s Employer:______Full/Part time:______Position:______

Mother’s Estimated Monthly Income:$______

Father’s Estimated Monthly Income:$______

Student’s Estimated Annual Income:$______

Expected Grants/Scholarships $______

Please list:

______

______

______

______

Student Loans:$______

Total Number of Children/ Dependents in household ____

Children in College ______Year in college and what college are they attending ______

Children at Home ______Grade and School attending ______

______

Primary language spoken in the home ______

I affirm that the information provided in this application is true and accurate.

Signature of Authorized Parent/Guardian:______Date:___/____/____

Parent’s/Guardian’s Printed Name:______

Student signature: ______

ALL INFORMATION MUST BE COMPLETED AND PROPERLY FILLED OUT TO BE CONSIDERED.

School Activities:

Please list the name of the organization, years of participation and any positions held

Example: Girl Scouts -- Officer 3 years-- member for 10 years

Chess club -- member --- 1 year etc.

1.______

2.______

3.______

4.______

Academic Achievements: Example: Member of Who’s Who, honor roll student, etc.

1.______

2.______

3.______

4.______

Community/Volunteer Service Work:

1.______

2.______

3.______

4.______

List other organizations which you are applying for a scholarship:

______

I understand that if I do not send in the proof of enrollment by September 30, 2012, I may lose any scholarship awarded.

SCHOLARSHIP RECIPIENTS MUST BE PRESENT AT THE AWARDS LUNCHEON

SUNDAY, MAY 20, 2012 AT 12:00 NOON AT

Teibel’s RESTAURANT, 1775 US 41, Schererville, INDIANA