CYPRESS COLLEGE FOUNDATION 2018 SCHOLARSHIP APPLICATION (You must use the 2018 application form; earlier versions will not be accepted)

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CYPRESS COLLEGE FOUNDATION 2018 SCHOLARSHIP APPLICATION (You must use the 2018 application form; earlier versions will not be accepted) Applications available in the Cypress College Foundation office, the Cypress College Financial Aid office or online at www.cypresscollege.edu MINIMUM SCHOLARSHIP REQUIREMENTS - 9 or more units completed at Cypress College in the fall 2017 semester - Cypress College grade point average (GPA) of 2.5 or higher - Complete a minimum of 9 units in the spring 2018 semester at Cypress College - Will enroll at Cypress College in the fall 2018 semester with a minimum of 9 units (Exceptions: those applying for the limited number of transfer scholarships) - Resident of the state of California GENERAL INFORMATION Scholarship awards generally range from $250 to $1,000, with some as high as $2,000. All candidates who include a legible email address on their application will be notified by email, by mid-april, 2018. Those who have won scholarships will be invited to participate in our annual ceremony on May 14, 2018. Most scholarship funds are held until fall enrollment is verified and after the fall drop- Page 1 of 8

date has passed (usually about the third week of the fall semester). However, a few scholarship checks are distributed at the scholarship ceremony in May. Page 2 of 8

DIRECTIONS - Complete application. It is extremely important that the scholarship application is 100% complete, and that the directions are followed to the letter. Failure to answer every question, in the exact manner required, will result in your application being disqualified. - It is strongly recommended, though not required, that you attach a letter of recommendation from an NOCCCD faculty or staff member. This letter cannot be from anyone who sits on the scholarship committee and must be from a faculty or staff member from North Orange County Community College District (Cypress College, Fullerton College, School of Continuing Education or NOCCCD District offices). - Attach a copy of your Cypress College transcripts. The transcripts may be unofficial and can be printed from MyGateway. If you do not attach your transcripts, your application will be disqualified. - Submit application no later than 5 pm, Thursday, February 15, 2018, to the FINANCIAL AID OFFICE. Faxes will not be accepted. Applications may be mailed, but postmarks are not proof of delivery. Applications must be stamped as accepted by the Financial Aid office prior to 5 pm, Thursday, February 15, 2018 no exceptions, regardless of the mailing date. Page 3 of 8

STUDENT INFORMATION Choose one: Mr. Ms. First Name: Last Name: Address: City: Zip: Student ID: @ Email: Do NOT list your Social Security number in place of your student ID number. If you do not know your student ID number, check with the Admissions and Records Office. EDUCATION Cypress College units completed to date: GPA: Units enrolled (or planning to enroll) in for Spring 2018 semester: (must be enrolled in a minimum of 9 units) Units complete from other colleges: Degrees earned: Major: If RN, Psych Tech, Rad Tech, Dental Hygiene or Mort Sci major, have you been officially accepted into the program? Yes No Career Goal: Do you plan to enroll in a minimum of 9 semester units during the Fall 2018 semester at Cypress College? Yes No STUDENT'S FINANCIAL INFORMATION Mark one: Single Married Do you reside with your parent(s)? Yes No (If yes, complete the box below) Page 4 of 8

Are you dependent on them for any expenses? Yes No How many other dependent children live at home? Father's occupation: Monthly Gross Salary $ Mother's occupation: Monthly Gross Salary $ Do you have dependent children? No Yes Ages: Page 5 of 8

STUDENT'S FINANCIAL INFORMATION (Continued) Your occupation: Monthly gross salary $ Spouse s occupation: Monthly gross salary $ Do you receive a Board of Governor s fee waiver (BOGG)? Current Pell Grant and/or Cal Grant amount received per semester $ List your employment since June of 2017: Employer Job Title Dates (from/to) Hourly Rate ESSAY On a separate sheet of paper, please submit typed answers to the following questions. Limit your answers to a maximum of three (3) double-spaced, typed pages. ***Handwritten essays will be disqualified*** 1) List and explain all pertinent information relating to your participation in extra-curricular activities. Include college activities (student government, committees, clubs, intercollegiate athletics) and community activities (church, service clubs, volunteer work.) If you do not participate in any extracurricular activities, please explain. 2) If you have more than 90 units complete, please explain why you have not yet transferred. Your application will be disqualified if you do not address this question. 3) Please describe in essay form: Page 6 of 8

a. The character traits you possess that have helped you to overcome personal adversity b. Your degree of commitment to pursue a college education c. How you anticipate making a contribution to society RELEASE If the below release is not signed and dated, your application will be disqualified. I hereby authorize release of all the foregoing scholarship and transcript information to any organization or individual involved in the selection of scholarship recipients. I also give permission to release my name to the donor and to media outlets for publicity purposes. Additionally, I understand that my picture will be taken and may be used in campus publications. Signature of Applicant Date Foundation Scholarship Check-List: Meet qualifications (9 units complete, fall 2017; 9 units in progress spring 2018; returning with a minimum of 9 units fall 2018 *exception: transfer student*; minimum GPA 2.5) All questions answered and all answers legible. No questions left blank. Unofficial transcripts attached Page 7 of 8

Essay typed, double-spaced, one-inch margins all around, 12 pt font, no more than three pages. Optional letter of recommendation from an NOCCCD staff or faculty member (maximum of two) Application signed and dated All pages of the application and all additional sheets stapled together. Do not put into report cover or binder. Page 8 of 8