Connecticut Higher Education Supplemental Loan Authority Scholarship Application: Academic Year

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Connecticut Higher Education Supplemental Loan Authority Scholarship Application: 2019-2020 Academic Year The Connecticut Higher Education Supplemental Loan Authority (CHESLA) is pleased to announce the CHESLA Scholarship for the 2019-2020 academic year. We are excited to award numerous scholarships to eligible undergraduates in pursuit of higher education in the State of Connecticut. ABOUT CHESLA The Connecticut Higher Education Supplemental Loan Authority is a quasi-public state agency created to help students and their families finance the cost of higher education. Serving as Connecticut s leading resource for students as they plan for their college education, not only by providing financing, but by providing information and tools for students to make informed decisions; enhance the competitiveness of Connecticut institutions of higher education by providing grants and additional financing options; encourage interest in higher education; and enhance economic development through innovative higher education programs. ELIGIBILITY CRITERIA In order to apply for this scholarship, an applicant must: Be a resident of the State of Connecticut Be an undergraduate student for the 2019-2020 academic year, enrolled at least half-time Be enrolled and attending an eligible Connecticut state or non-profit, degree granting institution of higher education in the 2019-2020 academic year Have an Expected Family Contribution (EFC) of $6,000 or less per the student s most recent FAFSA submission in 2019-2020 Have a minimum cumulative GPA of 2.5 (on a 4.0 scale) Not be in default on any CHESLA loans OTHER INFORMATION Scholarships will be awarded in July and checks will be sent directly to the college or university in August. Students attending on at least a half-time basis may receive up to $1,500 and full-time students may receive up to $3,000. Amounts awarded will depend on student s financial need and cost of program. The application and all required documents must be postmarked no later than May 10, 2019 and mailed to: Mail to: Natalia Rozio CHESLA 10 Columbus Boulevard, 7 th Floor Hartford, CT 06106 For any questions, please call or email CHESLA at: (860)520-4001 or nrozio@chesla.org

Applicant Information: Name (last, middle, first): Permanent Mailing Address: City State: Zip Code: Email: Phone Number: Name of Institution you are attending in 2019-2020: Gender and Race/Ethnicity: Completion of this section is voluntary and not required for the submission of an application. The information will not be used in awarding scholarships and will be used solely for statistical and reporting purposes. 1. Please state your gender: 2. What is your race/ethnicity? Please check the box that describes the race/ethnicity category with which you primarily identify. Hispanic or Latino White Black or African American Asian Native Hawaiian or Other Pacific Islander American Indian or Alaska Native Other: Two or More Races: a person who primarily identifies with two or more of the above race/ethnicity categories. CHESLA does not discriminate against any person in regard to race, color, religious creed, marital or partnership status, sex, sexual orientation, gender identity or expression, transgender status, national origin, ancestry, pregnancy, age, present or past history of mental, intellectual, learning, or physical disability, genetic information, veteran s status, prior conviction of a crime, or any other reason prohibited by any applicable law or regulation.

Academic History: HIGH SCHOOL BACKGROUND Name of High School: Actual or expected graduation date: / GPA : out of If your school does not use a traditional GPA scale, please provide the equivalent (e.g. class percentile/rank, High Pass, etc.). COLLEGE BACKGROUND School Attending in 2019-2020: Actual or expected graduation date: / Intended Degree (Associates or Bachelors): Classification for 2019-2020: Freshman Sophomore Junior Senior I attend: Full-time Part-time What is your Major Course(s) of study? What is your Minor Course(s) of study (if any)? What is your cumulative GPA? out of If your school does not use a traditional GPA scale, please provide the equivalent (e.g. class percentile/rank, High Pass, etc.).

Financial Aid Information: What is your Dependency Status for Financial Aid? Dependent Independent What is your Federal Expected Family Contribution (EFC)?: $ What is your cost of attendance as determined by your institution? Please verify with your institution s Financial Aid office. $ Have you ever received a Pell Grant? Yes No Please attach a copy of your financial aid award information for 2019-2020 (or substitute 2018-2019 if your current award information is not yet available). This must include the following components: cost of attendance, award information, and Satisfactory Academic Progress standing. A current printout from your institution s student selfservice portal is acceptable. If you have any other awards that are not indicated in your institution s financial aid award information, please include it below. Source Fall 20 Spring 20

Essay Responses: In the space provided, please answer the following questions. Additional attachments will not be considered. 1. Why do you believe you deserve this scholarship? How will it help you reach your career goals? 2. What community/school/volunteer activities do you participate in? Do you hold any leadership roles? Do you have a full-time or part-time job?

3. Optional: Is there any other information you would like the scholarship committee to consider when making their decision? Additional Requirements: The following must be attached to this application: 1. A copy of your most recent academic transcript. An unofficial academic transcript is acceptable. 2. Resume listing work experiences and involvement in school and community activities 3. One letter of recommendation from an academic, professional, or extracurricular reference 4. A copy of your financial aid award information for 2019-2020 (or substitute 2018-2019 if your current award information is not yet available). A current printout from your institution s student self-service portal is acceptable. 5. First two pages of your FAFSA SAR Report

I have enclosed the following materials. (Please note that incomplete applications may be ineligible for consideration.) Application Academic Transcript Letter of Recommendation Financial Aid Award Letter First Two Pages of SAR Report (Student Aid Report) Completed applications and all attachments must be postmarked by May 10, 2019 and mailed to the following address: Natalia Rozio CHESLA 10 Columbus Blvd, 7 th Floor Hartford, CT 06106 By signing below you are certifying that the information provided on this application is true to the best of your knowledge and is submitted under penalty of false statement as provided in Conn. Gen. Stat. 53a-157b. Knowingly providing erroneous or misleading information will render this application ineligible for consideration. Student signature Date This application must be printed, signed, and mailed.