Latinas in Progress (LIP) Education Series

Promotes the advancement of women through public, corporate, and civic life.

Latinas In Progress™ (LIP) Education Series

Dallas Chapter –Scholarship Application

Scholarship Application • Deadline: May 12th, 2017

PLEASE USE BLACK INK

To apply for a scholarship, you must be a Latina and a Senior in high school who has attended a minimum of threeeducation sessions of theHWNT Dallas Latinas in Progress™ (LIP) Education Series, in addition to meeting the requirements outlined in this application. Must be Present at the Scholarship Ceremony to receive Scholarship.

LIP Sessions Fully Attended 2016-2017 Academic Year. Please check all that apply:

HWNT Dallas Chapter • P.O. Box 670611• Dallas, TX 75367

Session 1: Orientation

Session 2: University of Texas Arlington

Session 4: Brookhaven Community College

Session 5: Southern Methodist University

HWNT Dallas Chapter • P.O. Box 670611• Dallas, TX 75367

Session 3: University of Texas at Dallas

I.PERSONAL DATA

Name:
(Last) / (First) / (Middle)
Address:
(Street) / (City) / (Zip)
Cell/Home Phone: / Email address:
High School: / Principal’s Name /
Parents’ Names:
(Father) / (Mother)
Number of Children at Home: / Number of Children in College:
Father’s Occupation: / Mother’s Occupation:
Will you be a candidate for need-based financial aid? / Yes
No
Are you currently employed? / If yes, where?

II. ACADEMIC PERFORMANCE

Class Rank: out of graduating seniors

WEIGHTED GPA: on a scale of (Indicate if you are on a 4.0 scale or other scale)

Enclose an official transcriptwith this application.

SAT Score: Math Reading Writing Total

ACT Score:

Please attach a copy of your SAT and/or ACT scores. Only one test score is required for this scholarship application.

III.SCHOOL AND COMMUNITY INVOLVEMENT

Please list extracurricularschool activities or organizations to which you belong. (Use a separate sheet if needed)

Please list activities or organizations outside of school to which you belong. (You may include the Class of 2017 Latinas in Progress Education Series!) (Use a separate sheet if needed)

What honors, recognition, or awards have you received? (Use a separate sheet if needed)

IV. COMMUNITY SERVICE

Please provide proof or documentation that you have completed a minimum of 12 hours of community service during the 2016-17 school year that was completed prior to the scholarship application deadline. A minimum of 12 hours is required for this scholarship application but feel free to include ALL hours of service from the 2016-17 school year. Don’t forget to indicate volunteer hours with HWNT. Some examples of acceptable community service include: HWNT, church, hospital, food bank, senior citizen center, Red Cross, YWCA, library, neighborhood association, middle or elementary school, etc. An example of unacceptable community service hours include: Helping out in family business.

V.REFERENCES

Please list three personal references. References can be teachers, counselors, employers, ministers, or activity/organization leaders, etc. (References from family members, friends, or close acquaintances are not allowed.) Please ask each of your references to complete the Reference Form. Be sure to include your name, address, and phone number on the Reference Form before you give the forms to your references. Your reference should return a sealed and completed Reference Form for you to submit to HWNT Scholarship Committee by the required deadline. An optional letter of recommendation may be included with the form. (Your reference can also mail their completed Reference Form directly to the Scholarship Chair at the address listed on the form.)

1.
(Name) / (Address) / (Telephone)
2.
(Name) / (Address) / (Telephone)
3.
(Name) / (Address) / (Telephone)

VI.ESSAY

Please type a minimum one full-page essay on the following topic using LIP Education Series Guidelines for Essay Writing. And please follow these guidelines as well: (12pt. Times New Roman font, 1 in margins, between 500-700 words)

Topic: Tell us about the most significant person, experience, or circumstance which has shaped your life thus far. How has she/ he, or it influenced your character? How might you use what you have learned to achieve your goals?

VII.COLLEGE/UNIVERSITY PLANS

Which universities / community colleges have you applied to and have been accepted.

What other scholarships have you applied for?

Which other scholarships have you received?

______

ATTACH ACCEPTANCE LETTER

Field of Interest/ Intended Major:__________

Please name the colleges or universities where you have applied and indicate whether you have been accepted:

1st Choice Name of School: ______

Have you been accepted? Yes No

2nd Choice Name of School: ______

Have you been accepted? Yes No

What other scholarships have you applied for?

______

VIII. HWNT SCHOLARSHIP AGREEMENT

I understand that any money awarded to me will be paid directly to the accredited institution I have chosen to attend OR will be reimbursed to me after I show proof of tuition payment. I must enroll for a minimum of twelve (12) college hours or vocational equivalent per semester (full-time student status.) Funds will be for tuition and school-billed fees. I understand that it is my responsibility to request funds in a timely manner from HWNT so that they can be paid to my academic institution prior to any payment deadlines. (Please allow one week for scholarship fund processing.)

I understand my name may be released to the media if I am selected as a scholarship recipient.

The Scholarship Committee will review each application on an individual basis. Each application will be reviewed and scored by more than three or more members of the committee. If a student has a mentor or a relative who is on the Scholarship Committee, the mentor or relative will not be allowed to evaluate that application. The committee’s decisions will be final and reviewed by the Scholarship Chair prior to notification of any award recipient. Failure to submit a complete Scholarship Application may cause the Scholarship Chair and/or committee to disqualify the application completely.

Scholarships will be awarded on a one-time basis for the upcoming school year and funds must be used within one calendar school year. I understand that if I do not enroll or if I withdraw from school during the time frame the scholarship was issued, any unused money will be returned to the Scholarship Fund of the Hispanic Women’s Network of Texas – Dallas Chapter. I also understand that any additional scholarship requirements of my academic institution must be met and maintained in order to receive my scholarship.

I certify that all my responses are true and factual. If selected as an HWNT scholarship award recipient, I will make efforts to give back to the LIP Education Series by volunteering at future sessions, being available to future LIP students for interviews, or special appearances at other HWNT events. In addition, I will also keep the HWNT LIP Education and Scholarship Chairs informed and updated with my address and contact information.

(Signature of Applicant) / (Date)

2017 HWNT SCHOLARSHIP APPLICATION CHECKLIST

*** IMPORTANT***

All of the following are required for submission of a complete application for review by the HWNT Scholarship Committee. Make sure you include the following in your packet:

HWNT Dallas Chapter • P.O. Box 670611• Dallas, TX 75367

❑Completed Application

❑Essay

❑Official Transcript

❑Copy of SAT and/or ACT scores

❑Documentation for Community Service

❑Reference Form #1

❑Reference Form #2

❑Reference Form #3

❑Make a hard copy or electronic copy of your packet to keep for your records

HWNT Dallas Chapter • P.O. Box 670611• Dallas, TX 75367

Deadline To Submit Your Completed Scholarship Application:
In Person Or By Mail Is May 12th, 2017

You have 2 options to turn in your HWNT Scholarship packet. Either option listed below is acceptable:

Email your completed application materials to the Scholarship Chair at

Mail in your completed Scholarship Application Packet with all Required Information which must be postmarked by May 12th, 2017 to:

HWNT DALLAS CHAPTER

PO Box 670611

DALLAS, TEXAS 75367

Students who are selected to receive our scholarships will be notified via phone.

Questions or for more information, contact the

HWNT Scholarship Chair Suzanne Estrada or AnaChrista Robles, Education Chair at

HWNT Dallas Chapter • P.O. Box 670611• Dallas, TX 75367