PACIFIC GAS AND ELECTRIC COMPANY HISPANIC EMPLOYEE ASSOCIATION 2009 HEA SCHOLARSHIP APPLICATION Background Information: The (HEA) of Pacific Gas and Electric Company (PG&E) shares a vision of excellence through Hispanic leadership. Our mission is to inspire and support Hispanics and employees of PG&E in achieving their goals and full potential within PG&E and the community, thereby enhancing our ability for shared success. In support of achieving these goals, HEA is awarding several scholarships starting at $500 up to $1,500 to eligible students who are graduating high school and enrolling in college or are currently attending college pursuing a degree. Qualifying Requirements: An applicant must be enrolled in college or planning to attend college in the fall of 2009. All eligible applicants must live within the PG&E service territory and must be able to provide a copy of a PG&E bill, upon request. The scholarships are awarded based on the information furnished by the applicant and evaluation by the HEA Scholarship Committee. A phone interview may be conducted at the discretion of the HEA Scholarship Committee. Applicants are required to submit all of the following: HEA Scholarship Application Copy of cumulative GPA (current official transcript) Letter of recommendation submitted by a teacher, faculty member, or school counselor An essay: two pages (maximum) double-spaced, 12-point font A PG&E bill, upon request (as proof of living within the PG&E Service Territory) Return completed application, postmarked by February 27th, to: Pacific Gas and Electric Company Attention: Carmen Jackson Scholarship Committee Mail Code B6F P.O. Box 770000 San Francisco, CA 94177 If you have any further questions, please contact Mario Valadez via email at m1v3@pge.com or by phone at (415) 973-7667. Thank you for your interest and we look forward to your participation.
Before filling out this application, please be sure to read the attached cover letter for all qualifying requirements. Please submit as early as possible, the completed application with necessary supporting documents. The application must be postmarked by February 27, 2009. PLEASE TYPE OR PRINT IN BLACK INK ALL INFORMATION. APPLICANT DATA NAME Last First Middle Phone (home) (cell) E-mail Address HOME ADDRESS Number Street Apt. # City State Zip DATE OF BIRTH Month Day Year SCHOOL DATA Students must include official school transcript showing cumulative GPA. Name of School Graduation Date Street City State Zip Cumulative GPA Counselor s Name Phone Name of postsecondary school applicant is planning to attend. If unknown, please list the schools to which applications or admission have been sent. If selected the recipient must supply proof of enrollment and student identification number in order to process the award. Name of School Name of School Name of School Intended major or field of Study
SCHOOL ACTIVITIES List all school activities in which you have participated during the past years (e.g., student government, community activities, sports, band, etc.) Description of School Activities (include name of faculty sponsor and email or phone number): FINANCIAL INFORMATION List your work experience(s) during the past 2 years. Indicate dates and approximate number of hours worked each week. Dates Hours Per Week What is your approximate annual income? $ If you re living with your family, what is the approximate annual household income? RELATIVE/DEPENDENT Does a relative work at PG&E? Yes No If yes, name of relative Relationship Contact # Does the applicant live with the employee for more than one-half of the year, and is the scholarship applicant not self-supporting? Yes No
Can the PG&E employee claim the applicant on their tax returns? Yes No Please note: Both relatives and dependents are eligible to apply to the PG&E HEA Scholarship. ESSAY TOPIC Select one of the following essay topics: (1) People and Events can shape our beliefs and lend direction to life. Some find life s purpose in volunteerism. Please describe a person, an event or a volunteer experience that left a lasting imprint on you and stirred the passion within. What significance did this person, event or experience have in influencing your decision on a higher education or your major? (2) One of PG&E s core values is to respect each other and celebrate diversity. Given your personal background, describe what diversity means to you and an experience that illustrates the importance of diversity. Prepare your essay using double-spaced, 12-point font with 1-inch page margins (two-page maximum). All of the information on this form is true and complete to the best of my knowledge. If asked by HEA, I agree to give proof of the information that I have given on this application. I realize that if I do not give proof when asked, I will not be considered for a scholarship. CERTIFICATION Signature of Applicant Date Signature of Parent/Guardian is needed if applicant is a minor. Signature of Parent/Guardian Date This application for a scholarship becomes complete and valid only when you return the completed and signed scholarship application, a current official transcript, a letter of recommendation and a typed essay. Incomplete applications will not be accepted. Scholarship applications received become the property of HEA. Application deadline is February 27, 2009. Only the selected recipients will be notified during the month of May. Selected recipients should be available to attend a presentation of awards which will be held in June/July 2009. Awards will be made payable directly to the school.
RETURN COMPLETED APPLICATION TO: Pacific Gas and Electric Company Attention: Carmen Jackson Scholarship Committee Mail Code B6F P.O. Box 770000 San Francisco, CA 94177 2009 HEA Scholarship Application Checklist: Completed HEA Scholarship Application Copy of cumulative GPA (current official transcript) Letter of recommendation submitted by a teacher, faculty member, or school counselor. An essay: two pages (maximum) double-spaced, 12-point font A PG&E bill, upon request, for proof of eligibility (applicants must live within the Pacific Gas and Electric service territory). Scholarship recipients will be asked to provide proof of college enrollment along with a valid student identification number in order to process awards.