Hispanic College Liaison Program (HCLP) SCHOLARSHIP APPLICATION

Top of Form

Eligibility:
This scholarship is offered to full time Hispanic students pursuing a bachelor’s or master’s degree in the fields of science, technology, engineering, and math. This program does not apply to graduating students. Applicants must be U.S. Citizens or Permanent Residents.
Applicant must have demonstrated leadership skills, resourcefulness, high personal standards and a personal commitment to helping the student organization, minority office and community achieve its goals on and off campus.
Please complete the following steps:
  1. Complete the application
  2. Submit an essay explaining why you are applying for the scholarship and why you would be the best applicant to receive a scholarship. Please include information about yourself such as academic background, extracurricular activities, career interests, financial need, involvement with the Society of Hispanic Professional Engineers (SHPE) and/or other minority organizations.
  3. Include both current and previous semester GPA and cumulative GPA. Provide details about GPA standing. An unofficial transcript from Goldmine will suffice.
  4. Scan and email all documents electronically to your local school contact (see below).
Note: Xerox has the right to withdraw a scholarship if the student drops out of school after being awarded the scholarship.
Last Name, First Name, Middle Initial
. / Student ID Number
. / Date
.
School Street AddressCity, State, ZipSchool E-mail AddressSchool Phone (include area code)
.
Home Street AddressCity, State, ZipPersonal E-mail AddressPersonal Phone (include area code)
.
U.S. Citizen or Permanent Resident?
☐ Yes☐ No / ☐ Black
☐ American/Alaskan
☐ Asian/Pacific Islander / ☐ Native American
☐ Hispanic
☐ Other / ☐ Male
☐Female
Name of 4-year Institution Attending
The University of Texas at El Paso (UTEP) / Cumulative GPA (or High School GPA, if Freshman) / Scale (e.g. 3.0 out of 4.0)
/ 4.0 / Expected Degree
BS ☐MS ☐ / Major Field of Study / Expected Date of Graduation
Are you currently (or were you ever) a Xerox HCLP Scholarship recipient? ☐ Yes☐ No
If yes, what year? . / School Standing?
Freshman ☐Sophomore ☐Junior ☐Senior ☐Graduate ☐
APPLICANT’S SIGNATURE ______DATE ______
My signature above indicates that I authorize schools officials to release my information to Xerox for inclusion in my application for the Hispanic
College Liaison Program (HCLP) Scholarships.
Completed application, essay and unofficial transcript should be scanned and emailed with subject line “2016 Xerox HCLP Application” to the local school contact by:
10:00am on September 19, 2016.
Local School Contact:
Gabby Gandara
Director, Engineering Student Services

(915) 747-6945

Bottom of Form