HESI COLLEGE SCHOLARSHIP

APPLICATION

March 04 2016

The Hispanic Student Society International (HESI) Scholarship Program provides monetary awards to graduating High School students who will be attending any college in the fall of each year. The total amount each student is eligible for is $1,000 to be split evenly between Fall and Spring semesters. Scholarships will be awarded at the start of each semester provided the student has maintained an overall 3.0 GPA or better. Scholarship awards require a minimum of 12 hours at registrars office can only be used for tuition and fees. All applicants will receive a “Hispanic Leadership Award” however the scholarships awards are selected by the board and only to winners selected. Since 2009, HESI has provided 30 scholarships and $30,000 to Seniors from the Humble Independent School District.

RULES AND INSTRUCTIONS

Eligibility and Qualifications:

To be eligible, 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 2016.

To qualify for consideration, the applicant must:

-currently, be a senior

-be at least 50% Hispanic or Latino using their natural born parents.

-demonstrate financial need

-present a record of academic success

-declare intent to fulfill the post-secondary school’s certificate or degree requirements

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

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

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

-take relevant courses toward their degree or certificate

-be in good standing with the school

-send a letter stating their OFFICIAL GPA INFORMATION to the HESI Scholarship Chairman below at the end of the Fall Semester to the HESI address below

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

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

LEADERSHIP & SCHOLARSHIP APPLICATION

PERSONAL INFORMATION

______

STUDENT’S NAME ADDRESSCITY/STATEHOME TELEPHONE

STUDENT ID# ______STUDENT SOCIAL SECURITY# ______EMAIL______

ALTERNATE PHONE______YOUR PERSONAL EMAIL ______YOUR PERSONAL CELL # ______

______

FATHER’S NAMEOCCUPATION & PLACE OF EMPLOYMENT

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

MOTHER’S NAMEOCCUPATION & PLACE OF EMPLOYMENT

ALTERNATE PHONE______ALTERNATE EMAIL ______

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

______NUMBER OF CHILDREN IN THE FAMILY ______

GUARDIAN (IF DIFFERENT)

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

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 PARTICIPATED IN

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

II. FINANCIAL INFORMATION

WILL YOU BE ABLE TO ATTEND COLLEGE WITHOUT FINANCIAL AID?

YES___ NO___

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

______

______

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

______

______

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

______I live with both 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.

MARK BELOW THE MOST ACCURATE COMBINED ANNUAL INCOME RANGE OF YOUR HOUSEHOLD, INCLUDING CONTRIBUTIONS BY 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 IDENTIFY ANYONE IN YOUR HOUSEHOLD WHO IS ATTENDING COLLEGE AND STATE WHERE WILL HE/SHE BE ATTENDING?

______

______

DESCRIBE ANY SPECIAL CICUMSTANCES THAT MAY AFFECT YOUR ABILITY TO PAY FOR COLLEGE:

______

______

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 - ______

ACADEMIC RECORD

  • WHAT IS YOUR HIGH SCHOOL GRADE POINT AVERAGE? (ON A 100-POINT SCALE)
  • WHAT CLASSES ARE YOU TAKING THIS YEAR? ______
  • WHICH, IF ANY, OF THESE CLASSES ARE DUAL CREDIT? ______
  • WHAT WILL BE YOUR COLLEGE MAJOR OR FIELD OF STUDY (If decided)?

III. PERSONAL REFERENCES

  1. IDENTIFY TWO TEACHERS OR ADMINISTATORS WHO KNOW YOUR WORK:

NAME ______TELEPHONE______

SUBJECTS TAUGHT ______

NAME ______TELEPHONE______

SUBJECT TAUGHT ______

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

NAME ______

______

ADDRESS TELEPHONE

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?

Name and Lenth of relationship?

V. ESSAY THAT YOU WROTE FOR THIS APPLICATION

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 described what it meant to you.

□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.

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 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 Signature Date

______

Parent/Guardian Signature Date

Student’s application mailed package must be postmarked by May 15th. 2016

RETURN THE COMPLETED APPLICATION TO:

Joe C. Ramirez

Hispanic Executive Society International

Attn: Scholarship Application

2607 Ridge Pine

Kingwood, Texas 77345

CONTACT HESI IN THE EVENT OF CHANGE RECEIVED AFTER THE ORIGINAL APPLICATE RECEIPT DATE. HESI RESERVES THE RIGHT TO ALTER OR WITHDRAW FINANCIAL ASSISTANCE. APPLICATIONS AND ALL INFORMATION SUBMITTED WITHTHE APPLICATION BECOME THE PROPERTY OF HISPANIC EXECUTIVE SOCIETY INTERNATIONAL. ALL SUBMISSIONS WILL BE KEPT CONFIDENTIAL, EXCEPT FOR REVIEW BY SCHOLARSHIP COMMITTEES.