Cecilia Montaner-Vargas Scholarship Application

CECILIA MONTANER-VARGAS AWARD
The Latino Civic Association of Tompkins County will consider:

High School student - Latinx/e seniors in good academic standing, who demonstrate community service involvement and who are graduating from any Tompkins County school district at the end of the 2023 school year; and

Non-traditional student - Latinx/e individuals who demonstrate community service involvement and who are returning to school, whether for an occupational training program or for college.

Please complete all sections of the application. The deadline for submission is May 1, 2023.

Note: All information provided in this application is considered confidential and will not be shared with any other organization. It will be used solely for scholarship applicant evaluation and to contact the applicants.
SECTION 1 - PERSONAL INFORMATION
Name
Date of Birth

MonthDayYear
Date
Home Address
Phone Number
Email address
example@example.com
SECTION 2 - ACADEMIC INFORMATION & POST-GRADUATION OR FUTURE
(PLEASE ATTACH A COPY OF YOUR TRANSCRIPT)

COLLEGETRADE SCHOOLOther
FIELD YOU ARE PLANNING TO MAJOR OR CONCENTRATE IN:
SECTION 3 - ACTIVITIES AND INTERESTS
List any extracurricular activities (e.g. memberships in organizations, sports, etc) and the dates you participated in each:
Brief description of how you participated:
List any volunteer activities in which you have been involved:
Brief description of how you participated:
List honors or academic awards you have received (e.g. scholarly activity awards, research awards, etc):
List your work experience below:
Employer #1
Position
Dates of Employment
Employer #2
Position
Dates of Employment
Employer #3
Position
Dates of Employment
SECTION 4 - SHORT ESSAY
Maximum word count: 250

On a separate sheet, please tell us what your education goals are and how you plan to contribute to your community. This may be attached as a separate document in your email or sent by mail, along with the additional required materials.
SECTION 5 - REFERENCES
Please provide two references we can contact to learn more about you (e.g. employer, pastor, teacher, or a community member – not a relative):
Reference #1
Name
Address
Email Address
example@example.com
Phone Number
Relationship to applicant
Reference #2
Name
Address
Phone Number
Email Address
example@example.com
Relationship to applicant
SUBMITTING YOUR APPLICATION

Please submit the following:

1. Completed electronic application form

2. Short essay emailed or mailed

3. One letter of recommendation from a teacher or a contact of any organization with which you have been involved.

4. A copy of your transcript

Please send the additional required materials by e-mail to:

lcaoftompkinscounty@gmail.com

or by mail to:

Latino Civic Association of Tompkins County

PO Box 6532

Ithaca, NY 14851

Deadline for receipt of this application and supporting documentation:
May 1, 2023.

PLEASE NOTE:

· To receive the monetary award, the winning student must send us written confirmation of enrollment in a post-secondary institution or program.

· The winner will send a brief report (one paragraph) by e-mail to the Scholarship Committee of the LCA to lcaoftompkinscounty@gmail.com by December 31, 2023.
Should be Empty:

CECILIA MONTANER-VARGAS AWARD

SECTION 1 - PERSONAL INFORMATION

SECTION 2 - ACADEMIC INFORMATION & POST-GRADUATION OR FUTURE

SECTION 3 - ACTIVITIES AND INTERESTS

List your work experience below:

SECTION 4 - SHORT ESSAY

SECTION 5 - REFERENCES

Reference #1

Reference #2