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State Council C Cabrillo C Civic C Clu ubs of Caalifornia, Inc. Scholarrship Commiittee
Applicatiion for an Undergradu U uate Schollarship INST TRUCTION NS: Applicattions will bee received at the office off the Chairpeerson of the S State Scholaarship Com mmittee betw ween January y 1st and March M 15th of o the year off application n. Applications postmarkked after March 15th will be disqualiffied. Mail applications a to the follow wing address:
Breeck Austin n State Schollarship Chairrperson 472 Paraadise View D Drive Vistaa, CA 920833 Phone: (760) 536-3575 Fax: (7 760) 536-3375 E-mail: teaamaustin87@ @att.net a willl be disqualified. Appliccations will not be acceppted or Appllication must be fully completed or applicant conssidered, if thee required doocuments arre not attached and the fo following reqquirements aare not met: 11. Applican nts must be of o Portuguese descent and a be a USA A citizen orr permanentt resident. 22. Applican nt must have maintained a minimum 3.50 Total Weighted Grade Poin nt Average for Grades 9 -12 and bee a graduatin ng Senior of a California high schooll. (An officcial High Scchool Transccript must aaccompanyy the applicaation ) 33. Applican nt meets all entrance reequirementss of the accreedited comm munity colleg ge, college, trrade school or univerrsity the app plicant plans to attend. 44. Applican nt must have participated d in at least three(3) t exttra-curricullar activities while in hiigh school. 55. Applican nt must preseent three(3) letters of recommend r dation from iindividuals w who will vou uch for the applicantt’s academic standing, ch haracter and personality. One letterr must be froom the Princcipal, Dean or Counsselor, verify ying particiipation in th he extra-currricular acttivities. Onee letter mustt be from a teacher of the high school atteended. One letter may bbe from any other sourcce except a relative and may be an additional teacherr. Individuaals writing leetters are to include theiir titles or poosition. 66. Applican nts must com mplete the Ap pplication for an Underg graduate Sch holarship, inccluding the eessay. Awaards are made on a competitive basis with consid deration beinng given to tthe following g categories: GPA A, Leadership p, Extra Currricular Actiivities, Work k(Paid or Voolunteer), Prromise and M Membership in Cabrrillo Civic Cllubs. The in ntent of the donors d of thiis fund is to assist studen nts of Portuguese descen nt who havee a desire to secure a high her educatioon. Schoolarships in the t amount of o $500.00 each e will be awarded a to SScholarship Recipients, u upon Verrification of o Enrollmeent in an accrredited comm munity colleg ge, college, trrade school oor universityy. Each h applicant will w be notifieed by June 30 3 th of the staatus of theirr application.. Additionaally, those appplicants who are awarded d a scholarsh hip will receiive award instructions foor collecting g the scholarship. Thiis application n is for the use u of applicaants applying g for admittaance into an ny accredited d comm munity colleg ge, college, trrade school oor universityy in the U.S.A.
2 The following information, together with the statements made by the Applicant is for the Cabrillo Civic Clubs of California Scholarship Committee only and will be kept strictly confidential.
Application for an Undergraduate Scholarship 20__ __ Name (Full Name)
Home Phone ( Cell Phone
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Mailing Address City
Zip
Home Address City
Zip
Email:
County High School is located in
Date of Birth
/
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American Citizen
(Yes, No)
Years at location
Birthplace (If NO are you a permanent resident)
Parents or guardians are a Cabrillo member Name of High School
(Yes, No) Club # Date of Graduation
Father’s Full Name
National Descent
Mother’s Full Name
National Descent
Mother’s Maiden Name Parents are:
Married
Single
Divorced
Widowed
(Yes, No)
3 For Committee Use Only - - DO NOT WRITE IN THIS SPACE - -
What is the Applicant’s Total Weighted Grade Point Average? (i.e. 3.40, 3.80) Is the Applicant a Life Member of C.S.F. Number in Applicant’s graduating class
(Yes, No) If No, how many semesters Applicant’s rank in class
According to our records the above statements are true and correct. Signed Title:
Date________________________ (Principal or Counselor)
Name of College Applicant planning to attend: Date of Entrance:
Major:
(i.e., Science, Business, English )
Name Business or Profession for which Applicant is preparing?
4 Answer the following questions as fully as possible: 1. List all extra-curricular activities in which Applicant participated (i.e., church, athletics, student body). Give years in which Applicant participated in each activity. (Add additional sheets as needed)
2. List employment(paid or volunteer) in which Applicant has been or are now engaged and give time periods of said employment (i.e., baby sitting, after school jobs, summer work)
3. Describe Applicant’s plans for the future in a short, biographical essay, (minimum of 250 words, attached on a separate sheet of paper). Add any other pertinent information that will assist the Scholarship Committee to better understand your qualifications.
I hereby declare I have read all of the statements on this application and to the best of my knowledge they are correct. Signed:
Date: (An electronic signature is an acceptable form of signature for application submission)
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