Asian/Pacific American Association for Advancement at AT&T

2005 4A-AT&T NATIONAL SCHOLARSHIP PROGRAM

STUDENT APPLICATION PACKET

Asian/Pacific American Association for Advancement at AT&T

2005 4A-AT&T NATIONAL SCHOLARSHIP PROGRAM

APPLICANT INFORMATION

The Asian/Pacific American Association for Advancement (4A) at AT&T has developed the 2005 4A-AT&T National Scholarship Program as a way to reach back into local communities to financially assist distinguished college students in continuing their higher education. The 4A National Scholarship Program will issue scholarship grants to qualified applicants who are selected primarily for their individual merit. Eligibility requirements will be used to initially screen applications prior to the actual review process. All third year college juniors currently enrolled full-time in an accredited undergraduate program in the United States are eligible to apply.[(] Candidates must be US Citizens or Permanent Residents.

After the initial screening process, the remaining eligible applicants will be evaluated based on their scholastic discipline, personal achievement, community involvement and contribution to the Asian/Pacific American community. Scholarship winners will be selected collectively by the 4A National Scholarship Committee based on a uniform, weighted point average system.

We will select three winners from the eligible applications postmarked by April 29, 2005. Each winner will receive $2,000 in award money to be used towards his or her higher education. The scholarship winners will be limited to one recipient per university.

Please complete the attached application and mail it along with a letter of recommendation addressed to you in a sealed envelope to the 4A-AT&T Scholarship Committee Member listed for that state in which your university resides. Please request your university to mail a copy of your college transcript to the same address. The application must be postmarked by April 29, 2005. Winners will be announced in July 2005.

Important Note: Before mailing in your application, check for the latest contact list at:
http://www.4a-att.org/National/scholarshipFAQ.html


State where University Resides: Mail to:

CT, ME, MA, NH, NJ, NY, OH, Suwathin Phiansunthon

RI, VT AT&T

4A National Scholarship Committee

200 Laurel Ave, Rm A5-2D05

Middletown, NJ 07748

CO, ID, MN, MT, ND, OR, SD, Darren Lum

UT, WA AT&T

4A National Scholarship Committee

5245 College Drive

Murray, UT 84123-2612

AZ, KS, NE, NM, TX, WY Debra Coker

AT&T

4A National Scholarship Committee

1355 W University Drive, Pod K3346

Mesa, AZ 85201-5419

FL, IL, IN, KY, MO, OK, TN, WI Jennifer Rose

AT&T

4A National Scholarship Committee

6021 S Rio Grand Avenue, Room 1E4-138

Orlando, FL 32809

AK, CA, HI, IA, NV June Tom

AT&T

4A National Scholarship Committee

795 Folsom Street, Room 2108D

San Francisco, CA 94107

DC, DE, MD, MI, PA, VA, WV Kung-Chang Lee

AT&T

4A National Scholarship Committee

3033 Chain Bridge Road, A-Q9.108

Oakton, VA 22185-2542

AL, AR, GA, LA, MS, NC, SC Daisy Sambo

AT&T

4A National Scholarship Committee

2800 Century Parkway NE, Room 04C21

Atlanta, GA 30345-3111

If you have any questions, please contact the 4A-AT&T Scholarship Committee at .

Important Note: Before mailing in your application, check for the latest contact list at:
http://www.4a-att.org/National/scholarshipFAQ.html

2005 4A-AT&T National Scholarship Application

PERSONAL INFORMATION

Name: Social Security #:

Permanent Address: Telephone:

Email:

Date of Birth:

Country of Citizenship: Ethnic Background (Optional):

If not a US citizen, are you a permanent resident? ______(yes or no)

Current Address: Telephone:

Address Valid Until:

Father’s Name: Mother’s Name:

Occupation: Occupation:

ACADEMIC PROFILE

College/University:

Address: Telephone:

City: State: Zip:

Anticipated Degree: Major/Minor:

Expected Date of Graduation:

Current cumulative GPA for the most recent academic calendar year (indicate scale):

FINANCIAL AID

Are you currently receiving financial aid from your university? ______(yes or no)

If yes, we will require that your financial aid office submit a letter confirming your participation.

(Please direct your college/university to mail a copy of your transcript and financial aid confirmation letter to the appropriate committee member and address listed on the front of the application by

April 29, 2005.)

EXTRACURRICULAR ACTIVITIES

Please list below your involvement in various extracurricular activities (e.g., community service, clubs, sports). For each activity, list the following: the name of the organization, a brief description, dates of participation, hours spent per week, your role/position in the organization, and a brief statement on the impact or benefit of this activity on you and/or the community (use separate sheets if needed). Please provide a contact name and reach number so that we can inquire.

Name of Organization (1): ______

Description of Organization: ______

Length of Participation (provide dates): ______

Hours spent per week: ______

Role/Position in the Organization: ______

Statement of impact or benefit of your Participation: ______

______

______

Organization Head: Name, Title & Telephone No.: ______

______

Name of Organization (2): ______

Description of Organization: ______

Length of Participation (provide dates): ______

Hours spent per week: ______

Role/Position in the Organization: ______

Statement of impact or benefit of your Participation: ______

______

______

Organization Head: Name, Title & Telephone No.: ______

______

EXTRACURRICULAR ACTIVITIES (continued)

(You may duplicate this page for additional extracurricular activities, if needed.)

Name of Organization (3): ______

Description of Organization: ______

Length of Participation (provide dates): ______

Hours spent per week: ______

Role/Position in the Organization: ______

Statement of impact or benefit of your Participation: ______

______

______

Organization Head: Name, Title & Telephone No.: ______

______

Name of Organization (4): ______

Description of Organization: ______

Length of Participation (provide dates): ______

Hours spent per week: ______

Role/Position in the Organization: ______

Statement of impact or benefit of your Participation: ______

______

______

Organization Head: Name, Title & Telephone No.: ______

______

ACHIEVEMENTS & AWARDS

Please list below any honors or awards you have received while in college. For each award, list the name of the award, the date, and the reason for the award (use separate sheets, if needed)

Name of the Award/Honor (1): ______

Date Award/Honor Received/Bestowed: ______

Reason for Award/Honor: ______

______

______

Name of the Award/Honor (2): ______

Date Award/Honor Received/Bestowed: ______

Reason for Award/Honor: ______

______

______

Name of the Award/Honor (3): ______

Date Award/Honor Received/Bestowed: ______

Reason for Award/Honor: ______

______

______

Name of the Award/Honor (4): ______

Date Award/Honor Received/Bestowed: ______

Reason for Award/Honor: ______

______

______

ESSAY

Please submit an essay of not more than 350 words (typed, double-spaced, separate sheet), on the following topic:

Are there diversity issues in the Asian American community that you can help improve? How might the 4A scholarship award help you in this regard?

Student’s Signature: Date:

Please submit this completed application by April 29, 2005 with the following attachments:

·  A letter of recommendation in sealed envelope

·  Essay

[(]* Children of the 4A National and Chapter Scholarship Committees, the 4A National Council and the 4A National Board of Trustees are not eligible to apply.