2018 Scholarship Application: Los Angeles Chapter, UC Berkeley Chicanx Latinx Alumni Association

UC BERKELEY CHICANX LATINX ALUMNI ASSOCIATION, LOS ANGELES CHAPTER

SCHOLARSHIP APPLICATION -- Deadline - Friday, June 15, 2018
Read and follow the instructions carefully prior to submitting your application. All winners will be notified in late August 2018.

Scholarship Application Instructions

The UC Berkeley Chicanx Latinx Alumni Association (CLAA) Los Angeles Scholarship supports undergraduate Chicanx Latinx students enrolled at UC Berkeley who demonstrate financial need for tuition, books, equipment, and living expenses. The number and amount of awards depend upon availability of funds as determined by the CLAA Los Angeles Scholarship Committee.

Scholarship awards are based upon four primary factors:

1.     Must have attended/graduated from a Los Angeles County High School or     Community College

2.     Current undergraduate class standing at UC Berkeley or     incoming Freshman/Transfer student

3.     Demonstrated financial need

4.     Written responses to questionnaire and one essay question

5.     Phone or in-person interview with a Scholarship Committee member if you are chosen as a finalist

A complete application package must include the following items:

1.     A completed and signed CLAA Scholarship Application

2.     Your current resume

3.     A picture of yourself

4.     A copy of your academic transcripts

5. A CalCentral print-out of your schedule of classes (current UCB students) or proof of enrollment at UC Berkeley (high school/transfer students)

6.     If you qualify for financial aid, please include a copy of your Financial Aid Award Letter or Student Aid Report (SAR).

* If you do not qualify for financial aid please fill out Section V.

If after thoroughly reading these instructions and you have any further questions regarding this application, please contact us at berkeleyclaa.la@gmail.com.
If selected, you will be asked for documentation to support the data you provide. Likewise, all correspondence and award agreements will be generated from the personal information submitted below. So, please use proper spelling, capitalization and punctuation.
I. Personal Data:

Tell us about yourself
Full Name*

PrefixFirst NameMiddle NameLast NameSuffix
Birthdate:*

MonthDayYear
Mobile No. :*

Area CodePhone Number
Email :*

Confirmation EmailWhere the confirmation will be sent to.
Home Address :*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Read and Understand the instructions.*

Yes, I have
Gender:
Ethnic Origin:

CaribbeanCentral AmericanChican@/MexicanSouth American
Please check veteran status (Check all that apply)*

VeteranChild of a VeteranGrandchild of a VeteranSpouse of a VeteranNone of the Above
Are you a first generation college student ?*

Yes, I am the first among my parents or grandparents to attend college.No, either my parents or grandparents have attended college.
Status at the time of application:*

I will be an incoming first year/transfer student in Fall 2018I will be a college Sophomore in Fall 2018I will be a college Junior in Fall 2018I will be a college Senior in Fall 2018
Academic Major*
Describe your career objective:*

0/300
II. High School Information:
Year of High School Graduation*
Most recent cumulative GPA:*
Describe your high school activities, community activities, volunteer work, honors, and any offices held.*
III. For Transfer Students Only:
Most recent college attended and cumulative transfer GPA:
School activities, honors, offices held, etc.:
IV. For Students Currently Enrolled at UC Berkeley:
Current GPA:
School activities, honors, offices held, etc.:
V. Financial Information
Do you qualify for Federal Financial Aid?*

Yes - If you qualify for Financial Aid fill out Section VI and submit a copy of your Financial AId Award Letter.No - If you do not qualify for Financial Aid please fill out Section V and VI below. (You may be required to show proof of income and financial need if chosen as a finalist.)
Household Income
Applicant's annual income
Father/Guardian Annual Income
Mother/Guardian Annual Income
Sibling Annual Income
Other Family Member Annual Income
Other Family Member Annual Income
VI. Student Budget
Student’s established budget for the 2018-2019 academic year (includes tuition, housing, parking, fees, books, etc.).*
Total financial assistance received (indicate TOTAL amount of combined loans, scholarships and grants).*
Parental contribution.*
Estimated wages for academic year.*
Student’s unmet financial need.*
VII. Questionnaire
1. Describe your personal and family background. (Max 250 words.)

0/250
2. Describe your educational objectives. (Max 250 words.)

0/250
3. Describe your past, present, and future community involvement. (Max 250 words.)

0/250
4. Describe any special circumstances affecting your need for financial assistance. How will this scholarship help? (Max 250 words.)

0/250
VIII. Essay
Your essay should be 400-500 words. In your essay please answer one of the following questions:
1. What do you consider to be one of the most important societal problem today? Why? In your response please address how you and your cohorts can work to resolve this issue.
2. What do you consider to be one of the most important policy issues facing Latinos today? Why? In your response please address how you and your cohorts can work to resolve these issues.
3. In what way do you see yourself making the biggest impact in your community?
Essay:

0/500
IX. Attachments
Current Resume*
Copy of Academic Transcripts*
CalCentral print-out (current students) or Proof of enrollment at UCB (high school/transfer students) *
Financial Aid Award Letter or Student Aid Report (SAR)
Your Current Picture *
Applicant Certification and Release of Information
Have you ever received a scholarship from CLAA before?

YesNo
I certify that I meet all eligibility requirements as specified in this application. I understand that meeting the minimum criteria and participating in an interview does not imply or guarantee I will receive a scholarship award.

I certify that all information in this application is true and accurate to the best of my knowledge and authorize CLAA to verify any information submitted as part of this application. I understand that falsified information will disqualify my application. If falsification is discovered after I have been awarded, I will be required to repay all funds awarded, plus interest.

I understand that application materials become the property of CLAA and will not be returned.

I understand that I must notify CLAA of any change in my enrollment status and that a change in full-time status (minimum of 13 units) may result in the cancellation of any award.

If selected as a scholarship recipient, I agree to submit a thank-you letter to the donors, a short biography, and an electronic picture of myself before I am able to receive my award. I also authorize CLAA to share or publish my biography and picture for promotional and fundraising purposes.

By signing (typing your legal name) in the space below, you are agreeing to the statements above, certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.
E-Signature:*
The UC Berkeley Chicanx Latinx Alumni Association is committed to equal opportunity in education. CLAA does not discriminate in any program or activity on the basis of race, color, religion, gender, age, national origin, disability, marital status, or any other protected class.
Should be Empty:

Now create your own Jotform - It's free!Create your own Jotform

UC BERKELEY CHICANX LATINX ALUMNI ASSOCIATION, LOS ANGELES CHAPTER

I. Personal Data:

II. High School Information:

III. For Transfer Students Only:

IV. For Students Currently Enrolled at UC Berkeley:

V. Financial Information

VI. Student Budget

VII. Questionnaire

VIII. Essay

IX. Attachments

Applicant Certification and Release of Information