2016-2017 Scholarship Application - Los Angeles Mission College

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Los Angeles Mission College - Financial Aid & Scholarships Office and Foundation Office

2016-2017

SCHOLARSHIP APPLICATION PART I: INSTRUCTIONS AND DESCRIPTION OF PROCESS 

All scholarships are intended for use in the 2016-2017 academic year at Los Angeles Mission College (referred to as LAMC throughout this application), unless otherwise stated.



All scholarships are one-time awards, disbursed (or applied as a fee waiver, as in the Millie Dein Scholarship) during the Fall 2016 and Spring 2017 semester, unless otherwise stated.



You must have completed at least one semester at LAMC.



References to Grade Point Average (GPA) and prior units completed refer to units and grades from coursework completed in the Los Angeles Community College District (LACCD). Thus, your GPA will be calculated based on work at LAMC and all other LACCD colleges combined.



The application form must be typed or printed legibly in black or blue ink. If your application is not legible it will be returned to you. Returned applications must be corrected and re-submitted by the official deadline for consideration.



Attach a 500-word essay. In 500 words or less, explain why you believe you are the best candidate to receive a scholarship(s). Include personal information, hardships if any, and educational/career goals. Your essay must be typed (no handwritten essays). Omission of the essay will disqualify your application.  PLEASE NOTE, SOME SCHOLARHIPS WILL REQUIRE ADDITIONAL ESSAYS AND/OR WRITTEN STATEMENT’S



Have your selected LAMC faculty or staff member(s) complete the Confidential Scholarship Recommendation form(s) and return the form(s) to the Financial Aid & Scholarships Office by TUESDAY, MARCH 15, 2016. All scholarships listed below require at least ONE Recommendation form be completed, unless otherwise stated. Omission of the Recommendation form(s) will disqualify your application.



Be certain you meet all criteria listed for each scholarship for which you apply.



Return your completed application form, essay(s) and all other attachments to the Financial Aid & Scholarships Office by the official deadline of TUESDAY, MARCH 8, 2016 by 6:30 pm.

Los Angeles Mission College - Financial Aid & Scholarships Office and Foundation Office

2016-2017

SCHOLARSHIP APPLICATION _______________________________________________________________________________________________ Last Name First Name Middle Initial Student ID Number

PART II: STUDENT INFORMATION Educational Information College Major:

Educational Goal: Certificate

AA/AS

Will you attend LAMC in Fall 2016? Full Time

BA/BS

Part Time

Will you be transferring in Spring 2017? Yes

Other

I will not attend

No

If transferring, name of school?

Financial Information Are you self supporting? Yes No

Number of dependents

How many hours a week are you employed?

References List at least two LAMC Faculty or Staff members to whom you’ll be forwarding the Confidential Recommendation form:

1.

2.

3.

4.

Additional Information List your special awards, college achievements, community involvement, and any other special recognition for which you have been awarded or cited. 1. 2. 3. 4. 5. 6. 7. 8.

2016-2017 Scholarship Application Form [VER1 20131216] [DOC]

Los Angeles Mission College - Financial Aid & Scholarships Office and Foundation Office

2016-2017

SCHOLARSHIP APPLICATION _______________________________________________________________________________________________ Last Name First Name Middle Initial Student ID Number

PART III: SCHOLARSHIPS FOR 2016-2017 Below is a list of the available scholarships. Please check the scholarships that you wish to apply for. Be certain you meet all criteria listed for each scholarship. If you do not meet all of the criteria for the scholarship that you are applying for, you will be automatically disqualified.

Please check the scholarships you wish to apply for: Graduating/Transfer Student Scholarship (amount TBD)  3.0 minimum cumulative GPA.  Must show proof by submitting a copy of the graduation petition.  If a student is transferring, he/she must have completed 56 transferable units.  Submit two Confidential Scholarship Recommendation forms from Faculty. Full Time Student Scholarship (amount TBD)  3.0 minimum cumulative GPA.  Must intend to re-enroll at LAMC Fall 2015.  Completed at least 30 units.  Enrolled in 12 or more units at the time of application.  Submit two Confidential Scholarship Recommendation forms from Faculty. Part Time Student Scholarship (amount TBD)  3.0 minimum cumulative GPA.  Prior completion of at least 6 units at LAMC.  Enrolled in 6 to 11.5 units at time of application.  Submit two Confidential Scholarship Recommendation forms from Faculty. Toye Jessica Tong & Dr. Eloise Fernandez-Cantrell (1 award of $250.00)  Currently enrolled with the Culinary Arts Institute (CAI).  3.0 Cumulative GPA.  Held a minimum of one Leadership role within CAI.  Have shown potential for Industry success (i.e. placed in competitions, community service, advanced leadership roles, and volunteering commitment while in the CAI program).  Recommendation from Department Chair with approval from Ms. Toye Jessica Tong & Dr. Eloise Fernandez-Cantrell.  A California Resident as determined by Admissions & Records.  Ability to attend the LAMC Scholarship Ceremony. Carla Bowman Scholarship (2 awards, amount TBD)  LAMC student with the intent of transferring to a university to pursue a degree in Life Sciences.  3.0 minimum cumulative GPA.  Must intend to re-enroll at LAMC Fall 2016.  Completed 30 or more units with a minimum 8 units in Life Sciences.  Carrying 12 or more units at the time of application.  Show potential for academic success by providing examples of written works, such as a term paper. Submitted written examples must be typed.  Submit two Confidential Scholarship Recommendation forms from Faculty.

2016-2017 Scholarship Application Form [VER1 20131216] [DOC]

Los Angeles Mission College - Financial Aid & Scholarships Office and Foundation Office

2016-2017

SCHOLARSHIP APPLICATION _______________________________________________________________________________________________ Last Name First Name Middle Initial Student ID Number

David Lee Moss Memorial Scholarship (amount TBD)  LAMC student transferring at the end of the Spring 2017 semester to a university to pursue a degree in Social Sciences. (Please attach any transfer documentation). Associated Student Organization (ASO) Scholarship (2 awards, $240 each award) The ASO provides awards for two students who have provided service to the college and to the community.

  

Must be a paid ASO member. 2.0 minimum cumulative GPA. This scholarship is available for continuing and transferring students.

AMP Art Supplies Scholarship ($100-$200 LAMC bookstore voucher, number of awards TBD)  Enrolled in at least one studio art course at LAMC in Fall 2016.  Previously completed at least one studio art course at LAMC with an A, B, C or P grade (or be enrolled during Spring 2016).  Provide a list of art course(s) you are planning to take in Fall 2016.  Include in your essay if you are a Veteran, current of former Foster Youth, or part of EOP&S/CARE, and/or CalWORKSs programs.

Gerald P. Scheib Scholarship for the Visual Arts (2 awards, $250 each award)  Attend school in LACCD.  Intend to pursue a career in the fine arts.  Have a cumulative GPA of 2.0 and a GPA of 3.0 or higher in art classes.  Provide samples of original work.  Be available for an interview.  Submit an essay of 300 words or less, answering the following: Why pursue art? What does it represent for your future? Describe an event in your life that inspired your passion in art. Describe a person in your life that inspired your passion in art. How can your art affect the world around you? Laptop Scholarship (number of awards TBD) All laptops are intended for use for courses taken at Los Angeles Mission College 

       

Submit a written statement explaining why you believe you are the best candidate to receive a laptop. Include personal information, hardships if any, and educational/career goals. This information can be included in your general 500-word essay. Must have completed at least one semester at LAMC. Must be enrolled in 6 or more units per semester. Demonstrate financial need. Must demonstrate good citizenship. 2.0 minimum cumulative GPA. GPA will be reviewed at the end of Spring 2016 semester for Fall 2016 award consideration. Recipient cannot receive a Laptop Scholarship more than one time. Recipient must write a “Thank You” letter to the Foundation Board of Directors expressing their gratitude.

2016-2017 Scholarship Application Form [VER1 20131216] [DOC]

Los Angeles Mission College - Financial Aid & Scholarships Office and Foundation Office

2016-2017

SCHOLARSHIP APPLICATION _______________________________________________________________________________________________ Last Name First Name Middle Initial Student ID Number

Sylmar Woman’s Club- Continuing ($500) One award of $500 is granted annually to a continuing LAMC student. The Sylmar Woman’s Club Scholarship Committee will select a candidate based on the documentation and a personal interview.

    

Resident of Sylmar who plans to continue at LAMC for Fall 2016. United States citizen or eligible non-citizen. 3.0 minimum cumulative GPA. Completed 30 units by Fall 2016. Submit a Confidential Scholarship Recommendation form from a Faculty member, counselor or career advisor.

Sylmar Woman's Club- Transfer ($500) One award of $500 is granted annually to an LAMC transfer student. The Sylmar Woman’s Club Scholarship Committee will select a candidate based on the documentation and a personal interview.

     

Resident of Sylmar who attends LAMC. United States citizen or eligible non-citizen. 3.0 minimum cumulative GPA. Enrolled in a transferable academic program. Graduating from LAMC in Spring 2017 or Summer 2017 and have applied to a four-year university for admission in Fall 2017 (Please attach a copy of the Graduation Petition). Submit a Confidential Scholarship Recommendation form from a Faculty member, counselor or career advisor.

Residents for a Better San Fernando Community Empowerment Scholarship (1 award of $300) The intent of the Community Empowerment Scholarship is to promote academic excellence, social justice and community activism by rewarding dedicated local students that have displayed a willingness to serve the community while continuing their goals for a higher education. The scholarship will provide financial resources and mentorship to students with a commitment and passion to improving the quality of life in their community.

       

Be a resident of the City of San Fernando. Have a minimum 3.0 cumulative Grade Point Average (GPA). Be enrolled in 6 or more college units at the time of application. Intend to enroll in a community college or university in 6 or more units Fall 2016. Submit a typed 500-word minimum written essay or creative short-video describing: “What the City of San Fernando means to me, what I envision for its future, and how residents can help make that future a reality”. Submit one (1) additional letter of recommendation from a teacher, employer, and/or community-based organization that you have worked for, or other academic/professional reference. Submit the Scholarship Disclosure Form granting Residents for a Better San Fernando the right to publish submitted essays or short-videos on their website, Facebook or other medium. Be available as needed for an oral interview by a Selection Panel.  Upon selection the scholarship recipient will be encouraged to attend at least one San Fernando City Council meeting or community activity within one-year of the award.

2016-2017 Scholarship Application Form [VER1 20131216] [DOC]

Los Angeles Mission College - Financial Aid & Scholarships Office and Foundation Office

2016-2017

SCHOLARSHIP APPLICATION _______________________________________________________________________________________________ Last Name First Name Middle Initial Student ID Number

Marco Antonio Firebaugh Memorial Scholarship (TBD) Assembly Bill 540 (AB 540) was authored by Assemblyman Marco Antonio Firebaugh and endorsed by Governor Gray Davis. Enacted in January of 2002, this law exempts eligible non-resident students who have attended high school in California, and received a high school diploma or its equivalent from paying non-resident tuition at California’s public institutions of higher learning. When this legislation passed, several Los Angeles Mission College student leaders, in partnership with parents, faculty, staff, and community members, took the initiative to create the Marco Antonio Firebaugh Memorial Scholarship, formally known as the AB540 Scholarship, at Los Angeles Mission College.

     

Be a non-resident as determined by Admissions & Records. Be a continuing student at Los Angeles Mission College for the Fall 2016-Spring 2017 academic year. Must be enrolled in at least 3-12 units at the time of award disbursement. Must have a high school diploma or GED. Submit a wallet size photo with general 500 word essay (photo becomes property of the Marco Antonio Firebaugh Selection Committee, not to be returned). You must also attend five consecutive Dreamer’s Pathway committee meetings or participate in three Dreamer’s Pathways committee events.

Doris McClain/Annabelle Godwin Child Development Scholarship ($7,000 to be divided among successful applicants) The intent of these scholarships is to honor the contributions of Doris McClain and Annabelle Godwin by encouraging promising students to make a career commitment both academically and professionally to the Early Childhood Education field. The aim is to help quality students where modest assistance can aid to achieve their goal of a career and professional participation in the field. Recipients to be selected by the full time Child Development faculty.

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Completed nine (9) units in Child Development with a 3.0 minimum cumulative GPA. Currently enrolled in Child Development courses leading to a Child Development Certificate or a California Child Development Permit. Show evidence of professional involvement outside the college classroom. Submit a written statement describing career goals and professional involvement in Child Development. This information can be included in your general 500-word essay. Submit two Confidential Scholarship Recommendation forms completed by faculty, one which must be completed by a Child Development faculty member.

The Gumpert Child Development Scholarship ($7,000 to be divided among successful applicants) The Gumpert Child Development Scholarship is sponsored by Evelyn and Richard Gumpert to provide financial support for single parent students committed to pursuing the academic requirements for a career in the field of Child Development.

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Be a single parent currently enrolled at LAMC. Be pursuing a Child Development major. Be completing or have completed a minimum of 12 Child Development units by the end of Spring 2016 with at least 6 Child Development units already successfully completed with an cumulative GPA of 2.8 or higher. Submit an essay explaining career and academic goals, as well as a statement of financial need. This information can be included in your general 500-word essay. Submit two Confidential Scholarship Recommendation forms completed by faculty, one of which must be from a full time Child Development faculty member.

2016-2017 Scholarship Application Form [VER1 20131216] [DOC]

Los Angeles Mission College - Financial Aid & Scholarships Office and Foundation Office

2016-2017

SCHOLARSHIP APPLICATION _______________________________________________________________________________________________ Last Name First Name Middle Initial Student ID Number

Rosalie Hilger Achievement Scholarship (2 awards; $500 each, to be used for tuition and/or LAMC Bookstore) Ernest Hilger on behalf of the Hilger Family Trust has established these two scholarships in honor of his beloved wife of 45 years, Rosalie Hilger. Rosalie taught and guided students for 24 years as an Adjunct Professor at East Los Angeles Community College and Los Angeles Mission College’s Child, Family and Consumer Studies Departments. Rosalie was the Director of the Foster and Kinship Care Programs at Los Angeles Mission College and the regional coordinator for these programs. To honor Rosalie’s legacy and contributions to Foster Youth these scholarships have been established to assist students who have successfully met life’s challenges and have demonstrated a positive life path for themselves and their family. Eligibility:  Meet one or more of the following: o

Enrolled in Family and Consumer Science/Human Services curriculum regardless of stated major

o

Foster Youth (current, emancipated or former)

o

Unaccompanied Homeless Youth now adults

o

Family and Consumer Studies (FCS) student

o

Student coping with emotional and physical scars of childhood that they have overcome

o

Current or prior participants in Foster & Kinship Care Education (FKCE Programs)

Requirements: 

US Citizen or eligible non-citizen (lawful permanent resident) and a resident of the state of California for the last two years



Enrolled at Los Angeles Mission College (LAMC) (or cross enrolled between LAMC and other LACCD schools) as a full time student in an AA or AS matriculation outcome taking 12 units* per term, or part time student taking a minimum of 9 units* per term at Los Angeles Mission College (LAMC) (or cross enrolled between LAMC and other LACCD schools).



Approved Education Plan, signed off by faculty or approved counselor for each semester the scholarship is in effect.



Successfully completed a minimum of three (3) credits in any of the following areas of study at LAMC prior to application: o

Foster and Kinship Care Education (FKCE)

o

Family and Consumer Studies Programs at LAMC

o

Child Family and Education Studies Departments at LAMC



Meet and maintain satisfactory academic progress in all courses.



Submit an autobiographical statement (500-1000 words) demonstrating excellent leadership skills and positive goal oriented lifestyle achievements for success in meeting life’s challenges. This autobiography should demonstrate a “CAN DO ATTITUDE” and give specific examples of how you have applied the following self-affirmations in your life: I CAN I WILL I MUST



A list of extracurricular, leadership and volunteer activities to their community (**Scholarship recipients must provide 15 hours of approved documented community service to the college or other community organization for the scholarship to remain in effect**).



An official school transcript (course competencies must include course work in Family and Consumer Science / Human Services Curriculum regardless of stated major).



Three (3) letters of recommendation

2016-2017 Scholarship Application Form [VER1 20131216] [DOC]

Los Angeles Mission College - Financial Aid & Scholarships Office and Foundation Office

2016-2017

SCHOLARSHIP APPLICATION _______________________________________________________________________________________________ Last Name First Name Middle Initial Student ID Number

San Fernando Valley Food & Wine Scholarship (1 award of $1000)  Must have completed a minimum of 12 degree applicable units within the LACCD at the time of initial disbursement.  Must be enrolled in 12 or more unties for Fall 2016 & Spring 2017 at Los Angeles Mission College.  2.5 minimum cumulative GPA.  Scholarship is awarded for Fall 2016 an Spring 2017 semesters ($500 each semester).  Recipient must write a “Thank You” letter to the Foundation Board of Directors expressing their gratitude for the award. Millie Dein Scholarship (no monetary award; waives Enrollment Fees only)  Must be enrolled in 12 or more units per semester at Los Angeles Mission College.  Demonstrate financial need.  Must demonstrate good citizenship.  2.0 minimum cumulative GPA.  GPA will be reviewed at the end of Fall semester for Spring award consideration.  Award can only be applied to current Enrollment Fee charges and cannot be applied to prior semester/year charges.  Scholarship is awarded for Fall 2016 and Spring 2017 semesters. Maximum value of waived fees cannot exceed $598 per semester.  Recipient cannot receive Millie Dein Scholarship and BOG Fee Waiver simultaneously.  Recipient must write a “Thank You” letter to the Foundation Board of Directors expressing their gratitude for the award. Spanish American Institute Scholarship-Awarded Fall Only (amount and number of awards TBD) The SAI Scholarship is made available to provide financial assistance to deserving Latino students or students who support or advocate for Latino students.      

Candidates must complete a one-page, typed self-profile essay on background, interests, goals, and need for award, and indicate how he/she identifies with the Latino culture or the ways he/she supports or advocates for those of Latino descent. 3.0 minimum cumulative GPA. Completes Foundation application process. Full-Time Student (12 units per semester). Resident of Southern California between San Diego and San Luis Obispo. A willingness to interact with SAI and grant permission to publish award's ceremony photos on SAI website.

2016-2017 Scholarship Application Form [VER1 20131216] [DOC]

Los Angeles Mission College - Financial Aid & Scholarships Office and Foundation Office

2016-2017

SCHOLARSHIP APPLICATION _______________________________________________________________________________________________ Last Name First Name Middle Initial Student ID Number

Trustee Emeritus Mona Fields Scholarship (1 award of $500) The purpose of the Mona Fields Scholarship is to assist students who hope to enter the “helping professions”, such as teaching, law enforcement, allied health, administration of justice, early childhood education, etc.     

Must have completed a minimum of 12 degree applicable units within the LACCD at the time of initial disbursement. 3.0 minimum cumulative GPA. Submit an essay explaining career and academic goals. This information can be included in your general 500-word essay, and will be used to validate the helping profession requirement. Scholarship is awarded for Fall 2016. Recipient must write a “Thank You” letter to Ms. Fields and deliver the letter to the LAMC foundation office.

Osher Foundation Scholarship (awards up to $1000 per academic year; maximum of $500 per semester)  Must have completed a minimum 24 degree applicable units within the LACCD at the time of initial disbursement.  Must be enrolled at Los Angeles Mission College, at least half time (6 or more units) during all terms in which the award remains active in the 2016-2017 academic year.  Must have received and be receiving the California Community College Board of Governor’s (BOG) Fee Waiver.  Student must be meeting all satisfactory academic progress requirements, as defined for all federal aid programs within the LACCD, at time of application.  Awards will be adjusted based on enrollment status and determined as follows: o Full Time (12 units) = up to $500 per semester o Three-quarter time (9-11.9 units per term) = up to $375 per semester o Half time (6-8.9 units per term) = up to $250 per semester  Must demonstrate financial need and have unmet financial need after all other aid is considered.  Student must write a “Thank You Letter” to the Osher Foundation: The Foundation for California Community Colleges Attn: Resource Development 1102 Q Street Suite 3500 Sacramento, CA 95811  Students on academic probation will lose their eligibility for any future disbursement(s).

2016-2017 Scholarship Application Form [VER1 20131216] [DOC]

Los Angeles Mission College - Financial Aid & Scholarships Office and Foundation Office

2016-2017

SCHOLARSHIP APPLICATION _______________________________________________________________________________________________ Last Name First Name Middle Initial Student ID Number

Mayor Tom Bradley Scholarship- Osher Challenge (awards up to $1000 per academic year; maximum of $500 per semester)  Submit a 500 word essay discussing: “What is your impression of Mayor Tom Bradley?”  Must have completed a minimum 24 degree applicable units within the LACCD at the time of initial disbursement.  Must be enrolled at Los Angeles Mission College, at least half time (6 or more units) during all terms in which the award remains active in the 2016-2017 academic year.  Must have received and be receiving the California Community College Board of Governor’s (BOG) Fee Waiver.  Student must be meeting all satisfactory academic progress requirements, as defined for all federal aid programs within the LACCD, at time of application.  Awards will be adjusted based on enrollment status and determined as follows: o Full Time (12 units) = up to $500 per semester o Three-quarter time (9-11.9 units per term) = up to $375 per semester o Half time (6-8.9 units per term) = up to $250 per semester  Must demonstrate financial need and have unmet financial need after all other aid is considered.  Student must write a “Thank You Letter” to the Osher Foundation: The Foundation for California Community Colleges Attn: Resource Development 1102 Q Street Suite 3500 Sacramento, CA 95811  Students on academic probation will lose their eligibility for any future disbursement(s).

President’s Circle Scholarship- Osher Challenge (awards up to $1000 per academic year; maximum of $500 per semester)  Must have completed a minimum of 24 degree applicable units within the LACCD at the time of initial disbursement.  Must be enrolled at Los Angeles Mission College, at least half time (6 or more units) during all terms in which the award remains active in the 2016-2017 academic year.  Must have received and be receiving the California Community College Board of Governor’s (BOG) Fee Waiver.  Student must be meeting all satisfactory academic progress requirements, as defined for all federal aid programs within the LACCD, at time of application.  Awards will be adjusted based on enrollment status and determined as follows: o Full Time (12 units) = up to $500 per semester o Three-quarter time (9-11.9 units per term) = up to $375 per semester o Half time (6-8.9 units per term) = up to $250 per semester  Must demonstrate financial need and have unmet financial need after all other aid is considered.  Student must write a “Thank You Letter” to the Osher Foundation: The Foundation for California Community Colleges Attn: Resource Development 1102 Q Street Suite 3500 Sacramento, CA 95811  Students on academic probation will lose their eligibility for any future disbursement(s).

2016-2017 Scholarship Application Form [VER1 20131216] [DOC]

Los Angeles Mission College - Financial Aid & Scholarships Office and Foundation Office

2016-2017

SCHOLARSHIP APPLICATION _______________________________________________________________________________________________ Last Name First Name Middle Initial Student ID Number

PART IV: DISCLOSURES AND STUDENT CERTIFICATION     

 

Your Mailing Address, Email Address, and personal demographic information available in your college admissions record will be utilized and supplied, as needed, to the selection committee(s) of any scholarship(s) you have indicated for which you are applying. Your financial aid information, including information from a Free Application for Federal Student Aid (FAFSA), Board of Governors (BOG) fee waiver application, or other related documents or forms supplied to the Financial Aid & Scholarships Office, may be supplied to selection committee(s) of any scholarship(s) requiring such information. Missing information, documents, forms, or illegible information may disqualify your application from consideration. Changes or corrections to criteria in the scholarship listings due to internal errors, spelling mistakes, grammatical interpretations, or otherwise will not negate the intent of the donor and the understanding of the Financial Aid & Scholarships Office and Foundation Office in selecting, awarding, and disbursing scholarships to applicants. Scholarship disbursements may be made in the form of fee waivers or cash awards, as noted above or as determined by the Financial Aid & Scholarships Office and/or Foundation Office. Cash awards may be disbursed, at the discretion and determination of the Financial Aid & Scholarship Office, through the district Higher One disbursement system (the MyLACCDcard program). Additional details about the MyLACCDcard program are available at the Financial Aid & Scholarships Office. Awards may be rescinded if all qualifications are not met. Definitions of all terms in this application are determined by the Financial Aid & Scholarships Office and Foundation Office. Applicants with questions regarding the meaning of any word, phrase, sentence, or otherwise should contact the scholarship coordinator in the Financial Aid & Scholarships Office.

CERTIFICATION I certify that I have met the criteria for each scholarship that I selected/checked above. I consent to the release of my grades and/or other pertinent information for verification and press release purposes.

______________________________________________ Student’s Signature

______________________ Date

______________________________________________ Street Address

______________________ Phone Number

______________________________________________ City State Zip

FOR FINANCIAL AID OFFICE USE ONLY GPA _______

Enrolled Spr’16 Y

N

App complete?

Y

N

Units Completed _______

Transfer Student Y

N

Essay received?

Y

N

BOG?

N

Recommendations?

Y

N

Y

STAFF ________

Number of Rec forms _______

DATE ________

Other attachments?

2016-2017 Scholarship Application Form [VER1 20131216] [DOC]

Y

N

Los Angeles Mission College - Financial Aid & Scholarships Office and Foundation Office

2016-2017

SCHOLARSHIP APPLICATION _______________________________________________________________________________________________ Last Name First Name Middle Initial Student ID Number

PART I: EXPLANATION OF FORM AND USE Student Applicant: You must submit at least ONE completed Confidential Scholarship Recommendation form for consideration for any of the scholarships offered through the Financial Aid & Scholarships Office and Foundation Office. Make copies of this page BEFORE you submit the form to the Faculty and/or State member(s) you have selected to complete the form.

PART II: REQUEST FOR RECOMMENDATION To the Faculty or Staff member completing this form: The above student is applying for scholarship(s) and has given your name as reference. We would appreciate your evaluation of this student by checking the appropriate columns below. Leave blank those items of which you have no knowledge. Feel free to attach additional pages if necessary. PLEASE return this form to the Financial Aid Office on campus by TUESDAY, MARCH 15th, 2016 @ 6:30pm. EXCELLENT

VERY GOOD

SATISFACTORY

NOT SATISFACTORY

Shows initiative Dependability Attendance Integrity & Strength of Character Motivation & Ambition

How long have you known the student applicant? In what capacity? Please write a brief recommendation: (Feel free to attach additional pages if necessary.)

Print Name

Title

Signature

Date

Please return to the FINANCIAL AID OFFICE by TUESDAY, March 15th, 2016 @ 6:30pm

2016-2017 Scholarship Application Form [VER1 20131216] [DOC]