CALIFORNIA STATE UNIVERSITY, SACRAMENTO SCHOLARSHIP PROGRAM FOR FUTURE SCHOLARS CHECK LIST

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CALIFORNIA STATE UNIVERSITY, SACRAMENTO SCHOLARSHIP PROGRAM FOR FUTURE SCHOLARS CHECK LIST Please return your application along with the following documents to the address listed below. No application will be accepted without transcripts or recommendation letter. Incomplete applications will not be reviewed for selection. Completed application form Personal statement Certification OFFICIAL copy(s) of college/high school transcripts One (1) letter of recommendation If you need further information, please call (916) 278-6183. Student Academic Success and Educational Equity Programs CSU Scholarship for Future Scholars CSU, Sacramento 6000 J Street, Lassen Hall 2205 Sacramento, CA 95819-6068 APPLICATION DEADLINE: Monday, September 10, 2018

SCHOLARSHIP PROGRAM FOR FUTURE SCHOLARS ELIGIBILITY CRITERIA The CSU Scholarship Program for Future Scholars seeks to increase the college participation rate of students who are disadvantaged due to their socioeconomic and educational background. The awards are made to first-time freshman and new transfer students on the basis of their potential to benefit from University-level courses. A $1,000 (per student) scholarship will be awarded for the academic year and will be disbursed in two payments of $500.00 per semester contingent upon funding. The scholarship may be renewed for a year (a maximum of four continuous semesters) based upon the student's satisfactory academic performance and funding. Eligibility Criteria for First Time Scholarship Applicants: Scholarship recipients must meet each of the following requirements to receive award: 1. Graduate of a California high school; 2. Admitted at CSU, Sacramento as a new freshman or transfer undergraduate student in the Fall 2018 term; 3. Meet regular CSU admission requirements & maintain satisfactory academic progress as defined by the campus; 4. Be a California resident as determined by the CSU Admission and Records Office; 5. Enrolled on a full-time basis (minimum of 12 units per semester) at CSU, Sacramento during the 2018-19 academic year; 6. Successfully completed 12 units in Fall 2018 term in good standing to be eligible for the Spring 2019 award; and 7. Applied for financial aid and demonstrate financial need in accordance with Federal Guidelines. Eligibility Criteria for Second Year Scholarship Applicants: CSU, Sacramento may elect to renew this scholarship on a year-to-year basis contingent on funding. Scholarship recipients must meet each of the following requirements to receive award: 1. Maintain 2.5 or above GPA and satisfactory academic progress as defined by the campus; 2. Must have successfully completed a minimum of 24 semester units in the first academic year; 3. Apply and qualify for financial aid; and 4. Enrolled on a full-time basis (minimum of 12 units per semester). IMPORTANT: If your GPA drops below the required minimum of 2.5 or if you are enrolled for less than 12 units for the semester, you will be disqualified. Unless specifically stated, minimum GPA refers to overall cumulative GPA. If you do not meet the stated minimum requirements at time of award, you will not be awarded. Application Process: Applicants must submit a completed application along with OFFICIAL transcript(s) of all college work completed prior to the Spring 2018 term. A letter of recommendation and a personal statement must also be attached. For additional information, visit the Student Academic Success and Educational Equity Programs Website at http://www.csus.edu/saseep/scholarship.html or call (916) 278-6183

CSU SCHOLARSHIP PROGRAM FOR FUTURE SCHOLARS APPLICATION 2018-2019 Please complete the application and submit with personal statement, certification, ALL your academic transcripts and letter of recommendation. The application must be received by the deadline on SEPTEMBER 10, 2018. No application will be accepted without OFFICIAL transcripts or recommendation letter. Incomplete applications will not be reviewed for selection. Submit to: Student Academic Success and Educational Equity Programs CSU Scholarship for Future Scholars CSU, Sacramento 6000 J Street, Lassen Hall Room 2205 Sacramento, CA 95819-6068 PERSONAL INFORMATION: Name SSN/Sac State ID Last First MI Address City State Zip Telephone (H) (C) (W) Date of Birth Sac State E-mail Ethnic Affiliation please check (Optional) American Indian or Alaskan native. Tribal affiliation. Japanese Hawaiian Black, non-hispanic, including African American Korean Samoan Mexican-American, Mexican, Chicano Asian Indian Other Pacific Islander Central American Cambodian White South American Laotian Filipino Cuban Vietnamese Other Puerto Rican Thai Decline to state Other Latino, Spanish-Origin, Hispanic Chinese Other Southeast Asian Guamanian

Page 2 of 5 Class level at the time of planned enrollment at Sac State College/Major Minor Are you a California resident? Yes No School last attended Name/Address Where do you plan to live while attending college? On-campus housing With parents Other (specify below) Off-campus housing With relatives Please list any other scholarships you have applied to and/or have been granted: BIOGRAPHICAL & EDUCATIONAL INFORMATION Circle the highest year in school/college completed by your parents or guardians: Mother: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17+ Father: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17+ Guardian: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17+ How many siblings are living at home including you? How many siblings have attended or are currently attending college? FAMILY FINANCIAL STATEMENT The following information is used to determine financial history. What is the current occupation (list job or position, not place of employment)? Father Mother Self What were your parents /yours job five years ago? Father Mother Self

Page 3 of 5 Did you or your family receive any income during 2017-2018 from public assistance programs such as welfare, AFDC, Social Security, disability, etc.? Yes No If yes, list type(s) of aid During the past ten years, have you or your family received any income from a public assistance program such as welfare, AFDC, Social Security, disability, etc. Yes No If yes, how many years? Type(s) of aid Have you or your family ever participated in any publicly funded programs such as subsidized housing, employment/training programs (i.e., CETA), school lunch programs, etc.? Yes No If yes, list program(s) Do you or any other children in your family work primarily to contribute to household expenses? Yes No If yes, explain CURRENT FINANCIAL STATUS The following information is used to determine income eligibility. All applicants must complete this section. Please indicate income of parent(s)/guardian(s) even if you don't live with them: Father Mother 2017 Actual 2018 Estimated 2017 Actual 2018 Estimated Guardian 2017 Actual 2018 Estimated Total size of household [including applicant, parent(s)/guardian, dependent children and any other dependent(s)]: If you are independent of parental support: A. How long have you lived apart from parent(s)? years B. What is your (and your spouse's if married) total household income? 2017 Actual 2018 Estimated C. Number of dependents in household (self, children and spouse)

Page 4 of 5 Please TYPE your Personal Statement in which you address each of the following: Family background Achievement Academic potential Career goals Community work/leadership skills Financial need Any other information relevant to this application

Page 5 of 5 CERTIFICATION All of the information on these forms are true and correct to the best of my knowledge. I further certify that I will enroll as a full-time (minimum 12 units per semester) college student for the 2018/2019 academic year, be a graduate of a California high school, meet regular CSU admission requirements, and have applied for and be eligible for financial aid and use the Future Scholars Scholarship award towards expenses related to attendance at California State University, Sacramento. Signature: Date: