Estrella Mountain Community College
Scholarship Application

What Scholarship are you applying for?    
First Name:   Last Name: SSN:  
Address:       City:            State: 
Zip:                DOB:                  E-mail:
Are you an Arizona Resident? Yes No Do you have a high school Diploma or GED? Yes No                         
High School GPA Cumulative College GPA  Cumulative College Credits completed
Are you presently employed? Fulltime Part time Work-study Not employed
Marital Status:
Married Unmarried:  		Gender:
Male Female		 Do you have children that you support?
Yes   No 
Are you a re-entry student (a student who has had a year or more break in you education)? Yes   No
Ethnicity: 
Caucasian  Hispanic/Latino  African American  Asian /Pacific Islander  Native American  Other                  
Have you performed Community Service hours in the last year?
Yes   No 		If yes, how many community service hours have you completed
What is your anticipated enrollment for Fall 2007
Full Time (12+ hrs) Half time (6-11hrs) 
Less than half time (<6hrs)  		What is your anticipated enrollment for Spring 2008
Full Time (12+ hrs) Half time (6-11hrs) 
Less than half time (<6hrs) 
How many credits have you completed
at EMCC? 		What is your anticipated graduation/completion
date at EMCC? /
I am seeking a degree or certificate in
 		if other was selected please specify
What are your long term educational goals? (bachelors, masters etc)
Personal Statement: Please answer the following questions in the space provided.
(format/ spell check  functions are not available)
 
Why are you applying for a scholarship?
What are your educational and career goals, both short term and long term?
What community service activities have you participated in?
What challenges have you overcome in achieving your education? (financial, personal, medical etc..)
What life experiences have impacted you the most, and why?
How will you use your educational experience to give back to your school, community or society?

Student Authorization
Will you authorize MCCCD to use your name, likeness and biographical material from your
personal statement in promotional materials?  Yes   No 
 
Would you be able to attend scholarship functions?  Yes   No
 
 
By submitting this application, I certify that the information provided is accurate and correct to the best of my knowledge.
 If an award is made, I authorize Estrella Mountain Community College to release academic, financial and/or any other necessary information as required by the donor.

If a scholarship award is made, a letter of thanks will be required before scholarship funds are released.
Only hit the submit button once.