COMMUNITY COLLEGE SCHOLARSHIP APPLICATION FALL 2018 DEADLINE: JUNE 1, 2018

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COMMUNITY COLLEGE SCHOLARSHIP APPLICATION FALL 2018 DEADLINE: JUNE 1, 2018

SCHOLARSHIP APPLICATION CHECKLIST All students must first complete their program s study abroad application and pay the corresponding non-refundable first payment before submitting this scholarship application. For more information, please visit your program s brochure, or contact ACCENT at 415-835-3744 or info@accentintl.com. PART 1: COMPLETED SCHOLARSHIP APPLICATION PART 2: PERSONAL STATEMENT Please use a separate sheet for your personal statement. The essay should be one page typed (12pt font, single spaced), maximum. Please write about your plans for the future, including information about the steps you are taking to reach your goals, including ways that studying abroad may be related to these goals. Your essay can provide information about yourself, your family and background, your current activities, interests, employment, volunteer experience, educational achievements and goals, as well as any special needs, financial circumstances, etc. This information will help the scholarship committee to be more completely informed about you as an applicant. PART 3: ATTACH TWO LETTERS OF RECOMMENDATION (PROFESSIONAL OR ACADEMIC REFERENCES) Please submit two letters of recommendation along with your application. Recommendations may be from instructors, counselors, or staff members at your college, current or former employers, or another person in the community to whom you are not related who knows you and is familiar with your academic work and/or community activities (such as a coach, high school teacher, etc.). Letters should be on letterhead, and should provide the ACCENT Scholarship Committee insight into your personal qualities, character, special talents, academic attributes, financial hardships, etc. Remember that faculty, staff, and your other professional contacts are busy; please request recommendation letters a minimum of 2-3 weeks before the deadline, and provide them with information about the scholarship and study abroad program. ACCENT is not able to reach out to recommenders on your behalf, nor collect late submissions of recommendation letters. PART 4: ATTACH UNOFFICIAL TRANSCRIPTS AND COURSES IN PROGRESS Please submit an unofficial transcript, as well as a print-out of your current courses in-progress. These items can be obtained at your school s registrar s office. PART 5: SIGNATURE - Sign the last page of the application, unsigned applications will not be considered. PART 6: SUBMIT BY THE DEADLINE - All materials must be submitted together. Please scan and email your completed application (Parts 1-5) to scholarship@accentintl.com with the subject line: FIRST NAME_LAST NAME_APPLICATION or Mail your completed application to: ACCENT Study Abroad 870 Market Street, Suite 1026 San Francisco, CA 94102 *Mailed applications must be received by the deadline in order to be considered.

Important notes: Please confirm all components of your scholarship application are complete before submitting it to ACCENT. All materials must be submitted together. If sending electronically (preferable) all application materials should be submitted as individual PDF or Word documents in one email. Fields listed with an * are required fields Students awarded scholarships will be required to serve as ACCENT Community College Student Ambassadors. Student Ambassadors will be required to contribute at least two blog or newsletter articles related to their study abroad experience to be shared via ACCENT s social media networks, with the goal of encouraging other community college students at your college and beyond to pursue study abroad. ACCENT staff will work with students on the development of these posts. Students awarded scholarships will also be required to assist ACCENT in Social Media initiatives as they arise. Scholarship recipients are expected to be informed 3-4 weeks after the scholarship deadline via email. Contact ACCENT at info@accentintl.com or 415.835.3744 with any questions.

PROGRAM INFORMATION *Sponsoring school: COMMUNITY COLLEGE SCHOLARSHIP APPLICATION fields listed with an * are required fields *Title of study abroad program: *Program location: PERSONAL INFORMATION Name: (First, Middle, Last): *Study Abroad program in which you have enrolled: *Birth date: (Month, Date, Year) *Current address: (Street Address, City, State, Zip) *Permanent address: (Street Address, City, State, Zip) *Primary phone: Have you previously traveled, lived or studied abroad? If so, please list the country(ies) and duration of stay: OPTIONAL PERSONAL BIOGRAPHICAL DATA Gender: Number of children: Their ages: Marital status: Do you live with your parent or guardian? Yes No If yes, how many dependents are your parents and/or guardians supporting? Have either of your parents/guardians completed a four-year college degree? Parent/guardian 1: Yes No Parent/guardian 2: Yes No Ethnicity (select one): Hispanic or Latino - A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. Not Hispanic or Latino

Race (select one or more): American Indian or Alaska Native - A person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment. Asian - A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam. Black or African American - A person having origins in any of the black racial groups of Africa. Native Hawaiian or Other Pacific Islander - A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands. White - A person having origins in any of the original peoples of Europe, the Middle East, or North Africa. Describe any documented disabilities: FINANCIAL BACKGROUND *How do you pay for your educational and living expenses? *How do you plan to pay for your study abroad program? *I can pay from savings/out of pocket $ toward my study abroad program fees/living expenses. *My family has agreed to pay $ toward my study abroad program fees/living expenses. *Others have agreed to pay $ toward my study abroad program fees/living expenses. Please feel free to provide any additional information that will assist us in evaluating your financial need (others supported by you or your family, others in college, child care expenses, medical expenses, etc.) If you anticipate a reduction in income, please explain. EDUCATION Current college or university: *Are you enrolled full or part-time? *Are you currently working towards an Associate s Degree? *Number of college-level units completed: *Number of college-level units in progress:

*Cumulative GPA at your current college: *Have you attended any other colleges? If so, please list: *High school attended: (Name, location, graduation year) *Have you earned any degrees or certificates beyond high school? If so, please list the degree and school: *What is your intended field of study? *What is your career goal? *When do you expect to finish your studies? (Month/Year) If you plan to transfer to a four-year college, at which school do you hope to enroll? ACTIVITIES List organizations, clubs and extra-curricular activities in which you have been active during college: List community and/or volunteer activities: What college, community, or high school awards have you received? EMPLOYMENT Are you presently employed? Yes No Please provide us with more information about your work history, if applicable: EMPLOYER TYPE OF JOB DATES OF EMPLOYMENT HOURS PER WEEK

EMPLOYER TYPE OF JOB DATES OF EMPLOYMENT HOURS PER WEEK SIGNATURE I hereby certify that the information provided above is given freely by me and is accurate to the best of my knowledge. I give permission to release this information to the ACCENT Scholarship Review Committee, Coordinators, and its designee(s). In order to receive the ACCENT Community College Scholarship, I understand that I must attend the entire Study Abroad Program. If I am unable to attend the program, I understand that I must return the scholarship in full to ACCENT. I understand that if I am selected as a recipient of this scholarship, I will be serving as an ACCENT Community College Student Ambassador, and will be required to contribute at least two blog or newsletter articles total related to my study abroad experience (one during the program, one within 1-2 months of completion) to be shared via ACCENT s social media networks. The goal of these articles will be to encourage other community college students at my college and beyond to pursue study abroad. I agree to this stipulation and will work with the ACCENT staff while I am overseas and upon my return to the U.S. to fulfill this obligation. *By checking this box and entering my name below, I am electronically signing my application. I have agreed to submit this application by electronic means. By signing this application electronically, I certify under penalty of perjury and false swearing that my answers are correct and complete to the best of my knowledge. I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature. *NAME: *SIGNATURE: *DATE: Submit this application with: Personal statement Two letters of recommendation Copy of unofficial transcript Print out of courses in-progress All materials must be submitted together.