Achieving My Dreams Foundation, Inc.

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1 Achieving My Dreams Foundation, Inc. High School Senior s Scholarship Application Scholarship Deadline: April 30th Late submissions will not be accepted. Our mission is to provide academic scholarships to young adults and empower them to pursue a baccalaureate degree from an accredited institution of higher education. Scholarship Application_2016 Page 1

2 Achieving My Dreams Foundation Scholarship Application Please complete all sections of the application - type or write clearly. Deadline for submission is April 30th. SECTION 1 PERSONAL INFORMATION Name: Address: City/State: Home Phone: Date of Birth: address: Zip: Cell Phone: Are you a U.S. citizen or permanent resident? Yes No SECTION 2 ACADEMIC INFORMATION Name of High School: GPA: (Attach an official copy of your High School Transcript) 1 st Name of College/University: Address: Accepted: Yes No Pending 2nd Name of College/University: Address: Accepted: Yes No Pending Scholarship Application_2016 Page 2

3 Intended Major: SECTION 3 ACTIVITIES AND INTERESTS A. List and briefly describe your high school extracurricular activities (i.e. memberships in organizations, sports, etc.): Organization Involved Position Held Dates of Involvement B. List and briefly describe volunteer activities in which you have been involved: Organization Activity Dates of Involvement C. List honors or academic awards you have received (e.g. scholarly activities, research, etc.): Award/Honor Institution/Organization Date Scholarship Application_2016 Page 3

4 D. List and briefly describe any work experience: Position Employer Dates of Employment Brief description of your work responsibilities: SECTION 4 SHORT ESSAYS The short essay statements must be typed (12-point font, double-spaced, 1-inch margins); maximum word count 250 per question. Handwritten essays will not be processed. A. Statement on your life and career goals. B. How do you feel a higher education will prepare you for success, both in your intended major and in general? C. How will this scholarship help you achieve your higher education plans? SECTION 5 FINANCIAL ASSESSMENT Highest educational level of mother: High School Some College College Graduate Advanced Degree Highest educational level of father: High School Some College College Graduate Advanced Degree Number of siblings Number of siblings who have attended college Will you be applying for Financial Aid: Yes No Will you live: On-Campus Off-Campus At home Have you been awarded other scholarships: Yes No Application Components The required components of the Achieving My Dreams Foundation Scholarship application are: Scholarship Application_2016 Page 4

5 A completed and submitted application; Two (2) letters of recommendation; All letters should be written by someone who can attest to your character, interpersonal relationships, and academic achievements. Please note - letters written by family members or peers will not be accepted. A typed (12-point font, double-spaced, 1-inch margins) statement on your life, career goals, honors and awards, and participation in extra-curricular activities. The statement should include how this scholarship will help you achieve your dreams. (Handwritten and/or incomplete applications will not be processed; please do not exceed one page). Copies of official high school transcripts must be submitted with the application. Mailing Materials Mail all official documents to the Foundation at: Achieving My Dreams Foundation Attn: Scholarship Application Process P.O. Box 5202 Oxnard, CA Application Timeline February 1 st Scholarship Application available at each local high school Career Center. Applications will also be made available on our website. April 30th Deadline for submission of application and all components; postmark date accepted. May 18th All applicants winners will be notified of their status by this date. I certify that the answers I have provided above are true, correct and complete to the best of my knowledge and that I have not knowingly withheld any facts. If asked, I agree to provide the Scholarship Committee with proof or verification of any information provided on this form. I realize that failure to do so will remove me from consideration. I understand any falsification, misrepresentation, inaccurate information/claims or omission of facts are sufficient reasons to forfeit the scholarship award. Should the applicant be selected as a scholarship recipient, I give permission for the applicant s name, photo, and biographical information to be published. Name (Please print) Signature Date Signature of Parent or Guardian if applicant is under 18 years of age Date Scholarship Application_2016 Page 5

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