HESI “COLLEGE SCHOLARSHIP” APPLICATION

January 28, 2014

The Hispanic Student Society International (HESI) Scholarship Program provides monetary awards to graduating High School students and contingent on attending any recognized college in the next subsequent semester of college. To date, HESI has provided (11) scholarship to Humble ISD and plans to provide additional college Scholarships in 2013. The total amount each student is eligible for is $1,000 for the next semester of college to be attended. The scholarships will be awarded at the start of next semester, to be determined. provided the student has maintained a 3.0 GPA or better. Scholarship awards can only be used for tuition and fees. Priority will be given to the students who are economically challenged. In addition HESI awards Hispanic Students with leadership, community service and academic achievement. This application is for consideration of either the “Leadership Award” or the “Scholarship”, or both awards. Announcement of awards will be in the final week of the school year. EVIDENCE OF REGISTRATION TO HESI OF A MINIMUM OF 12 HOURS, IS REQUIRED BY THE STUDENT PRIOR TO DISTRIBUTION.

Eligibility and Qualifications:

To be eligible for the $1,000 scholarship award, a student must be graduating from a Humble ISD High School and will attend any accredited college, university, or approved post-secondary institution in the fall of 2014. To be eligible for the Hispanic Leadership award applicant must be a student in High School at any grade.

To qualify for consideration, the applicant must currently

-demonstrate financial need

-present a record of academic success

-complete this application IN FULL by deadline date

Scholarship recipients must adhere to the following while attending a post-secondary institution:

-maintain a grade point average (or equivalent) of 3.0 or better

-take a minimum of 12 credit hours each semester, or be a full time student at a recognized college

-take relevant courses toward their degree or certificate

-be in good standing with the school

-send a letter stating their GPA, and official Humble ISD records to the HESI Scholarship Chairman at the end of the Fall Semester to the HESI address below.

-Quest Seniors who are under different grading system can apply based on Teacher/Administrative approval of GPA equivalency as stated above.

Application packages for the HSSI Scholarship Program must include the following:

  1. A completed application form (typed or printed in black in) including essay.
  2. A current resume
  3. A current high school transcript
  4. A letter of recommendation from either a teacher or counselor

Student’s COMPLETED application package must be delivered to the address below or postmarked by May 01, 2014. Awards will be announced by May 10, 2014. An event will be held by HESI with parents invited to make the formal presentation of certificates to be determined (date and location)

GENERAL 2014 LEADERSHIP & SCHOLARSHIP APPLICATION

Class of 2014

INSTRUCTIONS: FOR BOTH SCHOLARSHIP COMPLETE THIS PAGE

______

STUDENT’S NAMEHOME ADDRESSPERSONAL CELL TELEPHONE

HOME PHONE # ______HOME ADDRESS______CITY______STATE___

STUDENT ID# ______EMAIL # ______STUDENT SSN# ______

ALTERNATE PHONE: ______ALTERNATE PHONE #:______

______

FATHER’S NAMEOCCUPATION & PLACE OF EMPLOYMENT

HIGHEST LEVEL OF EDUCATION of FATHER (High School, college, graduate school, etc.): ______

______

MOTHER’S NAME OCCUPATION & PLACE OF EMPLOYMENT

HIGHEST LEVEL OF MOTHER EDUCATION (High school, college, graduate school, etc.)______

______NUMBER OF CHILDREN IN THE FAMILY ______

GUARDIAN (IF DIFFERENT)

You may attach a separate resume of the following: LIST THE SCHOOL ACTIVITIES IN WHICH YOU PARTICIPATED, LIST THE CHURCH AND COMMUNITY ACTIVITIES, and LIST ANY SIGNIFICANT JOBS

LIST THE SCHOOL ACTIVITIES IN WHICH YOU PARTICIPATED

School Organization or Activity Name / Accomplishments and Offices Held / Grade
9 / 10 / 11 / 12

LIST THE CHURCH AND COMMUNITY ACTIVITIES IN WHICH YOU PATICIPATED

Organization or Activity Name / Accomplishments and Offices Held / Grade
9 / 10 / 11 / 12

INSTRUCTIONS: SCHOLARSHIP APPLICANTS ONLY NEED TO COMPLETE THIS PAGE

FINANCIAL INFORMATION

  1. WILL YOU BE ABLE TO ATTEND COLLEGE WITHOUT FINANCIAL AID?

YES___NO___

  1. HOW DO YOU PLAN TO FINANCE COLELGE (parents, loans, scholarships, etc.)?

______

______

  1. PLEASE PROVIDE NAMES AND AGES OF ALL PEOPLE LIVING IN YOUR HOUSEHOLD?

______

______

  1. IF YOU DO NOT LIVE WITH BOTH OF YOUR PARENTS, WILL THE PARENT WITH WHOM YOU DO NOTLIVE WITH CONTRIBUTE TO YOUR COLLEGE EDUCATION?

______I live with both of my parents.

______I live with one of my parents

______Yes, both parents will be contributing to my college education.

______No, both parents will not be contributing to my college education.

______Neither parent will be contributing to my college education.

  1. MARK BELOW THE MOST ACCURATE COMBINED ANNUAL INCOME RANGE OF YOUR HOUSEHOLD, INCLUDING CONTRIBUTIONS BY A “NON-RESIDENT PARENT”

□ $0-$14,000□ $15,000-$29,999□ $30,000-$44,999□ $45,000-$59,999

□ $60,000-$74,999□ $75,000-$89,999 □ $90,000-$104,999□ $105,000-$119,999

□ $120,000 or more * Please be advised that the a higher priority of the scholarships will be for

economically challenged family income

  1. PLEASE IDENTIFY ANYONE IN YOUR HOUSEHOLD WHO IS ATTENDING COLLEGE AND STATE WHERE WILL HE/SHE BE ATTENDING?

______

______

  1. DESCRIBE ANY SPECIAL CICUMSTANCES THAT MAY AFFECT YOU’RE ABILITY TO PAY FOR COLLEGE:

______

______

INSTRUCTIONS: FOR BOTH SCHOLARSHIP Award-COMPLETE THIS PAGE

LIST ANY SIGNIFICANT JOBS YOU HAVE HELD

Employer / Position/Duties / Years / Hrs/WK

LIST ANY SPECIAL HONORS OR RECOGNITION RECEIVED:

______

______

______

LIST THE COLLEGES YOU PLAN TO ATTEND:

1ST CHOICE - ______

2ND CHOICE - ______

3RD CHOICE - ______

I. ACADEMIC RECORD

  1. WHAT IS YOUR HIGH SCHOOL GRADE POINT AVERAGE? (ON A 100-POINT SCALE)

______

  1. WHAT IS YOUR CLASS RANKING? ______
  1. WHICH, IF ANY, OF THESE CLASSES ARE DUAL CREDIT? ______

______

  1. WHAT WILL BE YOUR COLLEGE MAJOR OR FIELD OF STUDY (If decided)?

______

INSTRUCTIONS: SCHOLARSHIP APPLICANT ONLY .. PLEASE COMPLETE THIS PAGE

III.REFERENCES

  1. IDENTIFY TWO TEACHERS WHO KNOW YOUR WORK:

NAME ______PHONE______EMAIL ______

SUBJECT TAUGHT ______

NAME ______PHONE______EMAIL ______

SUBJECT TAUGHT ______

  1. LIST ONE UNRELATED CHARACTER REFERENCE WHO KNOWS YOU AND YOUR FAMILY (NEIGHBOR, CLERGY, ETC.):

NAME ______

______

ADDRESSTELEPHONE

IV.LETTER OF RECOMMENDATION-

You are required to provide a letter of recommendation from either one of the teachers identified above or a counselor familiar with your circumstances. Which teacher or counselor will provide your recommendation? Please list name, High School Course, and phone & email contact information.

______

V.ESSAY

ON A SEPARATE SHEET OF PAPER, SUBMIT A TYPED PARAGRAPH ABOUT ONE OF THE FOLLOWING TOPICS:

□Choose a personor situation that impacted your life and describe how you were affected.

□Choose an issue of importance to you and explain the significance of that issue to yourself, family, community or your generation.

□Your Career Goals and what has influenced you to enter this career choice and where you intend on it taking you.

Please list all names provided herein with relationship with you and phone, email and or contact information.

INSTRUCTIONS: FOR BOTH SCHOLARSHIP AWARD COMPLETE THIS PAGE

VI.SIGNATURES

I accept the rules and regulations of this application and understand the decision of the scholarship committee is final. The information I have hereby provided on this application is correct and I hereby consent to the release of a copy of the above-named student’s transcript, GPA, class rank, and test scores.

______

Student SignatureDate

Parent/Guardian SignatureDate

______

STUDENT OR PARENTS MUST CONTACT HESI IN THE EVENT OF A FINANCIAL STATUS CHANGE. HESI RESERVES THE RIGHT TOALTER OR WITHDRAW FINANCIAL ASSISTANCE FOR ANY REASON. APLLICATIONS AND ALL INFORMATION SUBMITTED WITH THE APPLICATION BECOME THE PROPERTY OF HISPANIC EXECUTIVE SOCIETY INTERNATIONAL (HESI). ALL SUBMISSIONS WILL BE KEPT CONFIDENTIAL, EXCEPT FOR REVIEW BY THE HESI SCHOLARSHIP COMMITTEE

AND HESI BOARD MEMBERS DURING THE SELECTION ACTIVITY.

RETURN THE COMPLETED APPLICATION TO:

Hispanic Executive Society International

Attn: Scholarship Application

4501 Magnolia Cove Drive Suite 201

Kingwood, Texas 77345

Student’s COMPLETED application package must be delivered to the address below by May 01 st, 2014. Awards will be announced by May 10, 2014. An event will be held by HESI with parents invited to make the formal presentation of certificates. The time and location is to be determined.