CITY OF LA PUENTE SCHOLARSHIP PROGRAM GUIDELINES FOR ACADEMIC YEAR WHO SHOULD APPLY

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CITY OF LA PUENTE SCHOLARSHIP PROGRAM GUIDELINES FOR ACADEMIC YEAR 2015-2016 WHO SHOULD APPLY High School Seniors, Adult Education Students and Veterans Returning to School Students with the: 1. Ability to show merit by school behavior, school participation and at least a 2.5 grade point average or better. 2. Ability to demonstrate financial need. (Copy of federal tax returns required). 3. Ability to prove residency in the City limits. PROCEDURE FOR APPLYING High School Seniors Complete an application and submit it along with: Unofficial high school transcripts Copy of your parents Federal Tax Return for the prior year (2014) Three letters of reference from faculty or professionals who have personal knowledge of your character Adult Education Students Complete an application and submit it along with: Unofficial transcripts from the continuation (or adult) school you are attending Copy of your (and/or your spouse s) Federal Tax Return for the prior year (2014) Three letters of reference from faculty or professionals who have personal knowledge of your character Veterans Returning to School Complete an application and submit it along with Copy of your discharge papers from the armed forces (DD Form 214) Copy of your (and/or your spouse s) Federal Tax Return for the prior year (2014) Three letters of reference from commanding officers or professionals who have personal knowledge of your character 1

SCHOLARSHIP AMOUNTS The City will award scholarships that can be used towards tuition or books. The scholarships will be paid directly to the school where the applicant has been accepted or reimbursed to the student upon receipt of proof of expenditure. Once awarded a scholarship, a scholarship recipient will not be eligible for future scholarships from the City. ABOUT THE SCHOLARSHIP PROGRAM The Scholarship program was created to expand educational opportunities for students who have demonstrated financial need, good character and a strong desire to obtain a college education but without financial assistance would not be able to attend. Scholarships will be awarded to individuals who meet the criteria upon which the scholarship program is based. SCHOLARSHIP AWARDS Applications will be available beginning on March 31, 2015 and may be obtained at your school, at www.lapuente.org, the La Puente Community Center or at City Hall. All applications and supporting documentation must be received (not postmarked) at City Hall by Thursday, April 30, 2015 by 5:00 p.m. for the following fall semester of the academic year. A five-member committee will review all applications and supporting documentation and make its recommendations to the City Council in May. DEADLINE FOR APPLYING The deadline for applying for a scholarship for fall 2015 is Thursday, April 30, 2015. All applications must be received (not postmarked) by 5:00 p.m. at La Puente City Hall. Completed applications must include all required documentation to be considered. You will be notified if you are selected to receive a scholarship. The City Council will announce the scholarship recipients at a meeting in June. 2

RETURN THIS FORM TO CITY OF LA PUENTE ATTN: SCHOLARSHIPS RECREATION SERVICES DEPARTMENT 15900 E. Main Street La Puente, CA 91744 APPLICATION FOR SCHOLARSHIP FOR 2015-2016 ACADEMIC YEAR CITY OF LA PUENTE Name Last First Middle Address Number & Street City State Zip Telephone: Home Alternate Phone Social Security No. - - Birth date (Optional) Month Day Year Applicant Eligibility Criteria (You must be able to answer yes to the following questions to be eligible for this scholarship program) 1. Are you a resident of the City of La Puente whose legal domicile is within the City limits? 2. Can you provide proof of financial need? 3. Can you provide the appropriate tax returns for the previous Year 2014? Current Status: High School Senior Adult education Veteran returning to school High school from which you will or have graduated Year of high school graduation High school grade point average (Please attach a copy of your high school transcripts) Yes No Enrollment status: Entering college freshman Adult Education Student 3

Name of College/School you plan to attend Proposed Major Have you applied? Been accepted? (Date) (Date The following two questions are for veterans returning to school or adult education students. Have you attended a college or university at any time before? Yes No If yes, please list the schools below, the years attended, and the number of units completed ******************* Additional Applicant Information on Financial Need: (If you are a high school senior please have your parents/guardian answer questions 1-6.) 1. Are you: Married Unmarried (includes single, divorced, widowed) No. of dependents Ages (If applicable) List all people in household (Please include parents, spouse and self) Name Age Name Age 2. Do you receive support from other family members? If yes, what amount? $ Yes No From Whom? 3. Are you currently employed? Annual Income 4. If married, please provide spouse s annual income. $ 5. What is your total annual Household Gross Income? $ 4

6. List any household members that will be attending college during the 2015-2016 Academic Year. Full Part Name College Time Time _ (Applicant is to answer questions 7-9.) 7. Please provide a brief explanation of your need for scholarship funds. 8. Feel free to add any other information that demonstrates a financial hardship that affects your ability to attend college. 9. Please attach a biography, not to exceed 250 words, describing your desires and future goals. I hereby certify, under penalty of perjury, that all of the above statements are true and correct. (Signature of Applicant) (Date) Please attach the following (refer to scholarship program guidelines) Proof of residency in the City of La Puente Unofficial high school transcripts/discharge papers Copy of Federal Tax Return 2014 Three letters of reference A biography, not to exceed 250 words Remember, the deadline to submit the application is Thursday, April 30, 2015 at 5:00 p.m. All supporting documents must be submitted with the application by the filing deadline. If you have any questions, please feel free to contact the Recreation Services Department at (626) 855-1550. 5