The Adiba Shaby Scholarship Fund The California Community Foundation is pleased to announce the Adiba Shaby Scholarship for the 2015-2016 academic year. To be eligible for scholarship consideration, the student candidates must: Be accepted in or attending an accredited two or four year accredited college/ university OR pursuing a certificate program Have a current grade-point-average of 2.0 or higher Complete and submit application material by the due date, Friday May 1, 2015 Scholarship Terms 1. Students will receive a one-time award for the 2015-2016 academic year. Students may submit a new application by the application deadline next year. 2. Students must be 18 years old and be a high school graduate by the start of the 2015-2016 academc year. 3. Scholarship awards provide assistance for tuition, fees, books and supplies. Scholarship selection will be based on the students demonstrated financial need and/or special circumstances affecting their path to completing their education. Preference will be given to students from Venice High School, Westchester High School, and West LA College. However, selection is not limited to these populations. About Adiba Shaby: Application Materials must be received by Friday, May 1, 2015 to: scholarships@calfund.org or Scholarships California Community Foundation 221 S. Figueroa Street, Suite 400 Los Angeles, CA 90012 Adiba Shaby immigrated to the United States in 1961. As a young woman, Adiba received a quality education in her home country of Iraq. She recognized that this was a rare opportunity for women of her time and valued the opportunity afforded to her. Pursuing her love for learning, she graduated from Pepperdine University and founded Harmony Pre-School. Adiba followed her life long desire to help individuals pursue their own educational goals. As a result of her dedication, the Adiba Shaby Scholarship Foundation was established in 1997 as means to support students from economically disadvantaged communities in Los Angeles. In 2004, the scholarship program found its home at the California Community Foundation and has continued to support students since her death in 2006.
The Adiba Shaby Scholarship Application 2015-2016 Academic Year Please complete the application. All fields are required for eligibility. Student Information Name Last First Middle Address Street City State ZIP Code Primary Telephone ( ) Date of Birth / / E-mail Address: High School Student: Yes No High School Name Cumulative GPA Graduation date College Student: Yes No College/University Name Cumulative GPA Anticipated Graduation date I am a past recipient of the Adiba Shaby Scholarship: Yes* No If yes, please contact us at scholarships@calfund.org as our application for past recipients has changed. Educational Plans College attending in the fall of 2015: Accepted? Yes No Intended Major Intended Degree: Bachelor Master Certificate Other Financial Information Student is: Dependent* Independent* *As defined by your college or university. Please check with your financial aid office for your correct classification. Please use your classification to complete the following financial information. Number of people in your household Number of people in household attending college full-time next year Family Gross Income Other Income 1
Available Income/Subsidy for 2015/2016 Instructions: Please list all financial resources you have available to support your education Scholarships and Grants: Please list the total amount of available public and private scholarships and grants. Please provide the total of all available Pell Grants, Federal Supplemental Educational Opportunity Grants, and Scholarships Loans: Include all public (both subsidized and unsubsidized) and private loans Family Support: List expected family contribution (EFC) as noted on your Federal Application for Federal Student Aid (FAFSA) Student Aid Report. If your circumstance is such that you do not anticipate receiving family support, please include any factors that may impact your family s ability to contribute to your education in the additional comments section. Scholarships/Grants Loans Family Support Employment Other Available Income Total Additional Comments: Additional Information A) Honors Received B) Extracurricular/Community Activities From/To Activity/Project/Result 2
C) Work Experience From/To Work Experience 3
Attachments Student statement In 500 words or less please respond to the following: Discuss any special circumstances or challenges you have faced. What are your career goals? What inspired you to select your particular course of study or vocation? Explain how receiving this scholarship would help you achieve those goals. Scholarship Terms I understand this scholarship is for a one year award for the 2015-2016 academic year. If I am interested in receiving another scholarship next year, I must submit a new application next year by the deadline. (Initial) I am/will be 18 years old and a high school graduate by the start of the 2015-2016 academc year. (Initial) I understand that if awarded, I will use the award from the Adiba Shaby Scholarship Fund for tuition, fees, books, and supplies only. (Initial) Certification Statement I certify that the information provided is complete and accurate to the best of my knowledge. If requested, I agree to provide additional information for verification purposes. Student Signature Date Application Materials Checklist (Due Friday, May 1, 2015): Student application Student statement Student academic transcripts (official or unofficial) Student financial information documents (FAFSA Free Application for Federal Student Aid Student Aid Report)* Please mail to: Scholarships California Community Foundation 221 S. Figueroa St. Suite 400 Los Angeles, CA 90012 Or email to: scholarships@calfund.org California Community Foundation employees and family members are not eligible for this scholarship. *If you are unable to submit a FAFSA Student Aid Report, please contact us at scholarships@calfund.org to discuss other supporting documents that you may submit in lieu of the Student Aid Report. 4