CSEA Chapter 270. Scholarship Application for Academic Year

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CSEA Chapter 270 Scholarship Application for 2015-2016 Academic Year Requirements to apply: Must be a Gavilan College CSEA member or have a parent or immediate family member that is a Gavilan College CSEA member. (Immediate family member is defined as: spouse, domestic partner, children, stepchildren and/or grandchildren) Must have a minimum cumulative GPA of 2.0 Submit a complete application packet which includes: Application (completed) Recommendation Form Personal Statement (2 page maximum please refer to personal statement specifications) Unofficial high school transcripts if you are a high school student or unofficial college transcripts if you are current college student. ~If you have received this scholarship in the past two academic years (2013-2014 or 2014-2015) priority will be given to NEW applicants.~ Please attach all documents in one packet. If selected, proof of enrollment must be submitted and funds will be disbursed a week before school starts for fall 2015. Applications can be found at: http://www.gavilan.edu/finaid/scholarships/index.html Deadline is Friday, April 11, 2015 before 5pm to Gavilan College Chapter 270 CSEA President or CSEA Scholarship Committee Member! Late and/or incomplete applications will not be considered. NO EXCEPTIONS! Mail to: Gavilan College CSEA Chapter 270 5055 Santa Teresa Blvd. Gilroy, CA 95020

Attn: CSEA President/Scholarship Committee

CSEA Chapter 270 Personal Statement Please print Your Name: Social Security Number: - - OR Gavilan ID Attach your personal statement to this sheet. It must be typed double space using maximum 12 point font and kept to a maximum of 2 pages. Your personal statement should provide the committee a sense of who you are, your career goals within your chosen major, any challenges faced and/or barriers you have overcome. Be sure to also include skills, community involvement, volunteer work, and significant accomplishments. Authorization for Release of Records I certify that all information presented in this scholarship application is true and correct to the best of my knowledge. I understand that providing false or misleading information will result in disqualification from the scholarship competition. I understand that if awarded a scholarship my name, photo and relative scholarship information may be released for Gavilan College publications, local newspapers, etc. I hereby authorize Gavilan College to release any information concerning my Academic Transcripts and Scholarship Application to any Donor and to the scholarship committee. Student s Signature Date Student s Name (Please Print)

CSEA Chapter 270 Scholarship Application Form Scholarships will be made on a competitive basis. Consideration will be given to all who have participated in extra-curricular/community involvement, academic merit, and: Complete Application Must be a Gavilan College CSEA members or have a parent or immediate family member that is a Gavilan College CSEA member (Immediate family member is defined as: spouse, domestic partner, children, stepchildren and/or grandchildren) Must have 2.0 GPA or better Provide Unofficial Transcript(s) Type a Personal Statement (Please refer to personal statement specifications) Have the attached Letter of Recommendation Form completed and included Name of applicant: LAST FIRST MIDDLE Mailing address: _ City: Zip _ Home phone number _ Have you received the Gavilan College CSEA Chapter 270 scholarship ever before? YES NO If you answered yes to the above question, what year did you receive? Name of Gavilan College CSEA member: Relationship to Gavilan College CSEA member: List all family members in your household. Include yourself, if you live with parents/guardians.

CSEA Chapter 270 Scholarship Application Form Work experience in which you have engaged, giving approximate periods, dates, and employer names. (Add additional pages if necessary) Employer Dates/Periods Position(s) Community or School activities in the last three years: Please list all extracurricular activities, such as volunteer work for Gilroy Garlic Festival, clubs, athletic participation, etc. (Add additional pages if necessary). Organization Dates Extracurricular Activities What is your career goal? What is your desired major? Do you plan to attend Gavilan College for 2015-2016 academic year? YES NO MAYBE List all Colleges & Universities you have been accepted to: Plan on attending? Yes or No Year you plan to attend the College or University? Student s Signature: Date: Attach : Application ( ) Recommendation Form ( ) Personal Statement ( ) Authorization for Release of Records ( ) Unofficial high school transcript, Unofficial Gavilan College transcript ( ) if high school student ( ) Important Deadline: Tuesday, April 1, 2014 before 5pm to Gavilan College CSEA President or Scholarship Committee Member

Student s Name: CSEA Chapter 270 Scholarship Letter of Recommendation Scholarships are awarded on academic performance, extracurricular involvement and in some instances on financial need. Please be specific regarding your knowledge of the applicant. PLEASE NOTE: This recommendation form should be put into a sealed envelope and given back to the student. If you do not want to complete this recommendation form, please advise the student accordingly. How long have you known this student? How well do you consider you personally know the applicant? Very well Fairly well Not very well Slightly Please rate all areas in which you feel you have adequate knowledge of the student. Check one box for each area and provide an overall recommendation. Ability Academic Achievement Leadership School Service Community Service Employment Record Overall Recommendation Outstanding Excellent Good Average Marginal Inadequate (Top 5%) (Top 10%) (Top 25%) Knowledge Comments: In a separate paper please provide all pertinent information you have regarding the applicant, including character traits and qualities. Name (Please Print) Relationship to applicant Signature: Date: Reminder, please return this form to the student in a sealed envelope.