Applicant Information
Name: ______________________________________________________________________
Home Address: _________________________City ___________________Zip code________
Phone: _______________________________ E-mail: ____________________________
Date of Birth: ___________________
High School Name & Town: ____________________________________________________
To which Colleges, Professional or Technical Schools have you applied? (Use additional sheet if needed)
_______________________________________________________________________
Explain how you qualify as a Hispanic: (i.e. explain where you, each of your parents, and/or your guardians were born or grew up. Include grandparents if applicable):
________________________________________________________________________
Tell Us About Your Academics
Your Class Rank: _______ out of a total class size of ________ graduating seniors
Your GPA: _______ out of a maximum possible GPA of ________
Your Fluency in:
Speaking Spanish: ____ Excellent ___ Good ___ Fair ___ Minimal
Reading Spanish: ____ Excellent ___ Good ___ Fair ___ Minimal
Writing Spanish: ____ Excellent ___ Good ___ Fair ___ Minimal
Your Family
Father/Guardian’s Name: __________________________________________________
Address: ________________________________________________________
Occupation: _____________________________________________________
Mother/Guardian’s Name: __________________________________________________
Address: ________________________________________________________
Occupation: _____________________________________________________
Siblings’ Names Ages Schools or Employers
____________________________ ______ _________________________________
____________________________ ______ _________________________________
____________________________ ______ _________________________________
____________________________ ______ _________________________________
Required Signatures
Signature of Applicant ____________________________________ Date _____________
Signature of Parent or Guardian ____________________________ Date _____________
Tell Us About Yourself
To assist us in the selection process for the HACC Scholarships, we want to know more about you. Please submit typed responses to each of the following questions. We will be evaluating both what you tell us and how you express yourself in writing. Your replies do not need to be long, but they should tell us enough that we get to know you better and understand your unique circumstances. (Please include the Title on each of your responses. e.g. “My Future Goals”; “My Hispanic Identity”; etc.)
– My Future Goals: Tell us about your academic interests, what you would like to study and what you are thinking about as an eventual career. Tell us why you want to pursue your chosen course of study. What do you imagine yourself doing in five years? Be specific.
– My Hispanic Identity: We know your family has Hispanic roots, but what does being Hispanic mean to you personally? How has your heritage shaped your life so far, and/or how has it influenced your future goals? What is it about your heritage that makes you who you are?
– My Most Important Activities/Achievements: We’d like to know what you consider to be your most important activities and achievements so far. What are you passionate about? What are your most meaningful or most personally-fulfilling activities, in or out of school? How have these experiences shaped who you are?
– My Financial Need: We all know college is expensive. Beyond that fact, what family or personal factors increase your need for financial help? How will this scholarship help you achieve your goals?
– Other Things to Know about Me: Everyone is unique. Is there anything we have not asked about that you would like us to know? Think about any personal, family or academic information you would like us to consider in evaluating your application. If there have been difficult circumstances, personal or academic, that you have had to confront, how you have coped with them can be important achievements to mention.
Mandatory Attachments
Please include all of the following with your Application:
– High School Transcript, including GPA, class rank, 1st semester senior grades.
– If the information does not already appear on your transcript, include a report from your High School that indicates the maximum GPA possible in your school’s grading system, and the size of your graduating class.
– Copies of 2 letters of recommendation. These may be letters that were submitted with your college applications; however, 1 letter MUST be from someone who is recommending you in a non-academic capacity. That person could be a coach, employer, religious advisor, club advisor etc. The letter cannot be from a family member.
A summary that lists your school and outside activities, awards or honors, community service, full or part time jobs, interests and hobbies, special talents, etc. This can be a resume you already prepared for your college applications (or for a job), as long as the requested information is included on it.
NOTE: This scholarship application is also available on our website:
https://hacc-chac.weebly.com. Look under: Contact-Us, Scholarship Application.