Local Scholarship Application Form

Jacob F. Elizondo, Scholarship Application (2019-2020), for a NSITE High School student only, formerly Business Careers High School.
The information provided on this form will be used by the Jacob F. Elizondo Committee to select recipients for scholarships. It is important that you give complete details concerning your college/career plans, activities and financial information.
BASIC INFORMATION
Student's Full / Legal Name
First NameLast Name
Student ID:
Student Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip CodeCountry
Student Phone Number
Area CodePhone Number
Student E-mail
Student Birth Date
MonthDayYear
Gender
Academics
Academic GPA of a 2.0
Schools to which you are applying
School 1
School 2
School 3
Will Live
Major(s) You Are Considering
In order of preference, list the major(s) you are considering (Very important for scholarship eligibility).
Major 1
Major 2
Estimated cost
School Type & Estimated Cost
PERSONAL DATA:
Elementary School(s) Attended
REFERENCES:
Please list one educator and at least one community person who would recommend you for a scholarship. Please do not list the person who completes a scholarship recommendation for you.
Reference 1 Name (Position,Phone Number. email)
Reference 2 Name (Position,Phone Number, email)

SCHOOL / COMMUNITY ACTIVITIES / WORK / EXPERIENCE/SPORTS/AWARDS/ETC:
List name of club, etc. and years of participation. If you volunteered, list the name of organization and the number of hours, weeks and years that you volunteered. If you worked, list the company, hours per week and length of time. Attach an additional sheet or resume if necessary.
School Activities (not sports)
School Activities (not sports)
School Activities (not sports)
Community Service / Volunteer Activities 1 (at school)
Community Service / Volunteer Activities 2 (outside of school)
Community Service / Volunteer Activities 3 (outside of school)
Sports Participation 1
Sports Participation 2
Will you be participating in a sport(s) this year?
Travel Experience or Unusual Experiences (study abroad, etc.)
School / Community Awards and Honors 1 (no matter how small) CSF, GSE, National Honor Society, Girl/Boy Scouts, 4-H, Governor’s Scholar, etc.
School / Community Awards and Honors 2
School / Community Awards and Honors 3
EMPLOYMENT 1: List past and present work and length of time employed.
EMPLOYMENT 2: List past and present work and length of time employed.

Needs-based Scholoarships Parent Financial Information
If you want your student to be considered for need-based scholarships, you will need to make available a copy of the first page of your most resent tax return and you must complete the information requested below. All information supplied by you will be treated as confidential. If you chose not to submit any financial information, your student will not be considered for need-based scholarships. Most donors require a financial statement. If your financial circumstances change after you have submitted this form, please feel free to contact us. Complete this entire page if you want your student to be considered for need-based scholarships.
Directions
Stepparent information may replace Mother or Father's information: Please report earnings for the parent/stepparent who the student has lived with most of the time (over 50%) in the past twelve months. If the student lives with both parents equally then provide answers about the parent/stepparent who provides the most financial support.
Father/Stepfather/Guardian Name
Father/Stepfather Employer and Occupation
Mother/Stepmother/Guardian Name
Mother/Stepmother Employer and Occupation:
Number of dependents in home:
First generation to attend college?
Father/Stepfather Annual Income :
Mother/Stepmother Annual Income :
Click to edit this text...
Other income that can be used for educational purposes (inheritance, college funds, etc)-do not include home equity, IRA's or other retirement accounts (optional):
Other Income Type 1:
Other Income Amount 1:
Other Income Type 2:
Other Income Amount 2:
Please explain any unusual circumstances such as, child-support ending, emergency expenses, medical bills, seasonal work, unemployment, etc.

SCHOLARSHIP RECEIVED TO DATE 1
AMOUNT 1
SCHOLARSHIP RECEIVED TO DATE 2
AMOUNT 2
STUDENT STATEMENT: In a few sentences, describe yourself .
Submission Time
MonthDayYearHourMinutesAM/PM Option

Essay Questions
On a separate sheet of paper(please print or type), unless there is adequate space below. Please answer the following` essay questions. There is no minimum or maximum lenght.

1. What was the most difficult event you have encountered in your life, and what did you do to overcome it?

2. Name a person who has inspired you to further your education. And why it meant so much to him/her?
Should be Empty:

Jacob F. Elizondo, Scholarship Application (2019-2020), for a NSITE High School student only, formerly Business Careers High School.

BASIC INFORMATION

Academics

Schools to which you are applying

Major(s) You Are Considering

Estimated cost

PERSONAL DATA:

REFERENCES:

SCHOOL / COMMUNITY ACTIVITIES / WORK / EXPERIENCE/SPORTS/AWARDS/ETC:

Needs-based Scholoarships Parent Financial Information

Directions