Academic Achievement Scholarship Application Spring 2015 Semester

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1 Academic Achievement Scholarship Application Due: Friday, October 31, 2014 IMPORTANT: This application is intended for students who DO NOT receive Financial Aid assistance and have COMPLETED one full semester at Manchester Community College.

2 Academic Achievement Scholarship Application TO: FROM: RE: MCC Student Applicant Endia DeCordova Dean of Development & Community Engagement MCC Foundation Scholarship Application Packet Manchester Community College Foundation Scholarship awards are being offered through the Institutional Advancement office for the. The awards are for current MCC students who have completed one full semester at MCC and are continuing their studies at MCC. Attached is the complete packet of information you will need to be considered for an award. The requirements for consideration are as follows: Full-time or part-time student GPA of 3.0 or better Completed one full semester at MCC Volunteer activities Progress toward a 3.0 GPA will be taken into consideration. Full-time and part-time students are encouraged to apply and past scholarship recipients are welcome to re-apply. The best assurance of attaining a scholarship is to turn in a complete application including a well-written essay that addresses the question asked on the application. The Counseling and Academic Advising center, located in the Lowe Student Services Center, L-108, and the Financial Aid Office, located in the Lowe Student Services Center, L-177, can provide information and assistance in completing parts of the application. The deadline for Spring 2015 semester scholarship applications is Friday, October 31, 2014 at 5:00 pm. Incomplete applications will be disqualified. There will be NO EXCEPTIONS for late entries. Mail or bring your completed application package to the Development office located in the Lowe SSC Building, room L-202. Questions should be directed to Zue-Jay Campos at or by to [email protected].

3 Academic Achievement Scholarship Application Checklist Only applications with the following information will be considered complete: Scholarship Application: Applicants must be a full-time or part-time student, enrolled in a degree or certificate-track program, in good academic standing with a GPA of 3.0 or better, completed one full semester at MCC, progress toward a 3.0 GPA will be taken into consideration; and volunteer activities. Do not leave anything blank. Two recommendations: From faculty/professional staff or community person. Applicants must ensure the recommendation forms are submitted by the deadline of Friday, October 31, One-page, typed essay: Essay should address one of the following questions: 1. Imagine yourself 10 years from today. What goals and ambitions do you have for yourself, personally and professionally? 2. Pick an experience from your own life and explain how it has influenced you. 3. Describe your family background. How has your family background affected the way you see the world? Transcript: Please include a copy of your current MCC college transcript. Resume: List any extracurricular activities and volunteer work (especially activities at MCC). Deadline for applications: Friday, October 31, 2014 Incomplete applications will be disqualified. Mail to: MCC Foundation/Scholarships, Great Path, MS #6, PO Box 1046 Manchester, CT In Person: Institutional Advancement Office, Lowe SSC Building, room L-202

4 Due: Friday, October 31, 2014 Academic Achievement Scholarship Application _ Applications not completed in their entirety will not be accepted PLEASE PRINT Name of applicant: Banner ID# last first m.i. Address: street city/town state zip code Phonetic spelling of your name: Date of birth Gender: Male Ethnicity: Hispanic/Latino White Black or African American American Indian/Alaskan Native Female Asian Native Hawaiian or Other Pacific Islander Other address: Date enrolled at MCC: Day-time telephone: (area code) Evening telephone: (area code) Anticipated graduation date: Work status: Full time Part time Unemployed Work Study Student: Yes No Academic degree program: Certificate program: Grade Point Average to date: Credits earned to date: The number of credits you are currently taking: Have you violated the student conduct policy within the last academic year? : Yes No If yes, explain: I am registering as a full-time student for the Spring semester. Number of credit hours I plan to take I am registering as a part-time student for the Spring semester. Number of credit hours I plan to take: Number of family members in college: Are you an international student? Yes No What is the highest level of education your parents achieved? Extracurricular activities and volunteer work Please list any extracurricular activities and volunteer work you participate in, especially at MCC Page 1 of 2

5 REQUIRED: Academic Achievement Scholarship Application College Transcript: Please include a copy of your current MCC college transcript. Students must have completed one full semester at MCC 2 Recommendations: Important: Obtain two (2) letters of recommendation from people who know about your qualifications. One letter must be from an MCC faculty or staff member. You may use the attached recommendation form or request that a letter be written on your behalf. Application Essay: On a separate sheet of paper, submit a one-page, typed essay. Please address one of the essay questions listed on the Academic Achievement Scholarship Application Checklist. Resume or Activities List: Please provide information on your volunteer or college activities and dates of participation. Volunteer activities can include community experiences or College activities. I have carefully read and completed this application and, to the best of my knowledge, the above information is true. I understand that this application material will be kept confidential. Signature Date Return/Mail completed application to: MCC Foundation / Scholarships Great Path MS#6, P.O. Box 1046, Manchester, CT or in person to Office of Institutional Advancement, Lowe SSC Building, Room L-202 Page 2 of 2

6 Scholarship Information Release Form Manchester Community College foundation scholarships are made possible through the contributions of various individuals and organizations. These donors appreciate learning more about the students who directly benefit from their scholarship funds. By allowing the College to provide recipient information to our donors, you are helping to strengthen their connection to MCC. We also like to share scholarship recipient information with the offices and organizations that work so very hard to raise scholarship funds for MCC students and for publicity releases. Your cooperation with the efforts of Manchester Community College s Marketing and Public Relations Department, Alumni Association, Development Department and MCC Foundation will help to increase the funds available to assist current and future MCC students with their education. The Family Education Rights and Privacy Act (FERPA) (20 U.S.C. 1232g; 34 CFR Part 99) is a Federal law that protects the privacy and confidentiality of student education records. In order for the College to release your information, we must have written permission from you. I authorize Manchester Community College to release my information and photo to donors and other individuals responsible for funding my scholarship(s). I also authorize Manchester Community College to release my information and photo for publicity releases and other promotional and/or marketing material related to Manchester Community College. Signature Date Printed Name. Banner ID

7 Due: Friday, October 31, 2014 RECOMMENDATION FORM FOR SCHOLARSHIP Name of applicant: (Please print) I have known the applicant for (period of time) I know this applicant as a (i.e., student, employee, work-study student, volunteer) Please rate the following characteristics of this applicant (select one characteristic per line). Academic Performance outstanding more than satisfactory average below average not applicable Character/Attitude outstanding more than satisfactory average below average not applicable Motivation outstanding more than satisfactory average below average not applicable Leadership Qualities outstanding more than satisfactory average below average not applicable Community Service outstanding more than satisfactory average below average not applicable Can you address the financial needs of this applicant? Yes No If yes, please explain. Please provide any information or support that you feel would assist the applicant in being selected as a recipient of an MCC Foundation Scholarship Award. Print Name Signature Title Date Please return to: MCC Foundation / Scholarships, Great Path MS #6, P.O. Box 1046, Manchester, CT

8 Due: Friday, October 31, 2014 RECOMMENDATION FORM FOR SCHOLARSHIP Name of applicant: (Please print) I have known the applicant for (period of time) I know this applicant as a (i.e., student, employee, work-study student, volunteer) Please rate the following characteristics of this applicant (select one characteristic per line). Academic Performance outstanding more than satisfactory average below average not applicable Character/Attitude outstanding more than satisfactory average below average not applicable Motivation outstanding more than satisfactory average below average not applicable Leadership Qualities outstanding more than satisfactory average below average not applicable Community Service outstanding more than satisfactory average below average not applicable Can you address the financial needs of this applicant? Yes No If yes, please explain. Please provide any information or support that you feel would assist the applicant in being selected as a recipient of an MCC Foundation Scholarship Award. Print Name Signature Title Date Please return to: MCC Foundation / Scholarships, Great Path MS #6, P.O. Box 1046 Manchester, CT