cien amigos – ime becas scholarship fund college scholarship

CIEN AMIGOS – IME BECAS SCHOLARSHIP FUND
COLLEGE SCHOLARSHIP & HIGH SCHOOL GRANTS APPLICATION
PLEASE PRINT OR TYPE INFORMATION.
APPLYING FOR:
___ COLLEGE SCHOLARSHIP
___ HIGH SCHOOL SCHOLARSHIP
NAME: _______________________________________________________________________________
LAST FIRST INITIAL
PLACE AND DATE OF BIRTH: _____________________________________________________________
HISPANIC ORIGIN: ____ MEXICAN ____ MEXICAN-AMERICAN ____ OTHER (SPECIFY): _______________
PERMANENT ADDRESS: _________________________________________________________________
NUMBER & STREET
_____________________________________________________________________________________
CITY COUNTY STATE ZIP CODE HOME PHONE #
E-MAIL ADDRESS: ________________________________ CELL PHONE #: ________________________
HOW DID YOU HEAR OF THE SCHOLARSHIPS?__________________________________ GPA: ________
ARE YOU CURRENTLY EMPLOYED? ____ YES ____ NO If YES, PLEASE INDCATE WHERE AND HRS/WEEK:
_____________________________________________________________________________________
FATHER: _____________________ PLACE OF BIRTH ____________ OCCUPATION: _________________
MOTHER: ______________________ PLACE OF BIRTH _____________ OCCUPATION: ______________
NUMBER OF SIBLINGS/RELATIVES, INCLUDING YOURSELF, LIVING AT HOME (EXCLUDING PARENTS):
_____________________________________________________________________________________
HAVE EITHER OF YOUR PARENTS ATTENDED ANY COLLEGE OR UNIVERSITY?: ______ YES ______ NO
NUMBER OF SIBLINGS CURRENTLY ENROLLED AT COLLEGE OR UNIVERSITY: ______________________
ARE YOU A STUDENT QUALIFYING FOR EXEMPTION FROM PAYING OUT-OF-STATE TUITION IN
CALIFORNIA WITH NO LEGAL RESIDENCE IN THE UNITED STATES (AB 540 STUDENT)?: ____ YES ___ NO
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ANNUAL HOUSEHOLD INCOME (TOTAL INCOME OF ALL MEMBERS OF YOUR HOME):
[ ] $24,999 OR LESS [ ] $25,000-39,999 [ ] $40,000-59,999 [ ] $60,000 AND UP
HAVE YOU APPLIED FOR OTHER SCHOLARSHIPS/GRANTS? ____ YES ____ NO
IF YES, PLEASE LIST NAMES AND AMOUNTS: _________________________________________________
_____________________________________________________________________________________
PLEASE ANSWER THE FOLLOWING QUESTIONS, COMPLETELY AND WITH DETAIL, ON SEPARATE, TYPED
PAGES. EACH QUESTION MUST BE ANSWERED IN 150-200 WORDS.
1) WHY ARE YOU STUDYING / PLANNING TO STUDY YOUR CHOSEN MAJOR?
2) WHY DO YOU NEED THE SCHOLARSHIP?
3) HOW WILL YOU USE YOUR COLLEGE EDUCATION TO HELP YOUR COMMUNITY?
4) WHAT OBSTACLES HAVE YOU HAD TO OVERCOME IN LIFE? HOW HAVE YOU DEALT WITH THEM?
5) HOW HAS YOUR CULTURE INFLUENCED YOU IN LIFE?
PLEASE INCLUDE THE FOLLOWING WITH YOUR APPLICATION:
1) A LETTER FROM A SCHOOL OFFICER, ON OFFICIAL SCHOOL LETTERHEAD, CERTIFYING YOUR
CUMMULATIVE GPA, OR A COPY OF YOUR LAST SCHOOL REPORT OR YOUR SCHOOL TRANSCRIPT.
2) A LETTER OF RECOMENDATION (FROM A PERSON NOT RELATED TO YOU, WHO HAS SUBSTANTIAL
KNOWLEDGE OF YOU AS A STUDENT AND AS A PERSON. THE LETTER SHOULD INCLUDE NAME,
TELEPHONE NUMBER AND RELATIONSHIP TO YOU --A PROFESSOR, EMPLOYER, ETC.--).
I CERTIFY THAT ALL THE INFORMATION IN THIS APPLICATION PACKAGE IS TRUE AND COMPLETE.
____________________________________ ____________________________________
SIGNATURE DATE
PLEASE MAIL OR DELIVER YOUR APPLICATION AND ALL REQUIRED MATERIALS TO:
Cien Amigos - IME Becas Scholarship Fund
c/o Consulate General of Mexico
2093 Arena Boulevard
Sacramento, CA 95834
DEADLINE TO SUBMIT APPLICATIONS: TUESDAY, MAY 15 th , 2012.
THE ENVELOPE SHOULD BE RECEIVED NO LATER THAN THIS DATE.
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