STANLEY BEHRENS FOUNDATION SCHOLARSHIP

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1 STANLEY BEHRENS FOUNDATION SCHOLARSHIP The Stanley Behrens Foundation Scholarship is awarded to an Orange County Community College Transfer Student who has demonstrated recognizable talents and will be attending UC Irvine in the fall of The award is a conditionally renewable $2,500 scholarship and is contingent upon the applicant being admitted to UC Irvine. ELIGIBILITY REQUIREMENTS: Minimum transfer GPA of 3.5; U.S. Citizen or Permanent Resident; Family income not exceeding approximately $110,000 annually; Highly motivated to succeed; Involved in charity or community affairs; While attending UCI, the student will: 1. Donate 90 hours of community service each school year to a cause of his/her choice; 2. Maintain a GPA of 3.0 or above; 3. Work for a salary no more than hours per week while school is in session; 4. Attend a comprehensive career counseling session in his/her intended career field during the summer after the first year at UCI; 5. Meet the Foundation representatives 3-4 times per year to set goals and to obtain assistance in reaching goals; 6. Live directly on the UCI campus while a recipient of the scholarship. (The Foundation prefers that students live on campus). APPLICATION PROCEDURE: Application deadline: Thursday May 5, 2016 (Must be received in the office by 5pm) Submit your complete application to: UCI Office of Financial Aid and Scholarships 102 Aldrich Hall Irvine, CA A complete application includes: Submission of a Stanley Behrens Foundation Scholarship paper application including your personal statement. Copies of unofficial transcripts from all post-secondary education. Letters of recommendation. Provide at least two letters of recommendation from teachers, counselors, etc who are able to attest to your talents, skills and character. Filing a Free Application for Federal Student Aid (FAFSA). The FAFSA can be filed at Submitting additional documentation, as requested. PLEASE NOTE: Finalists will be contacted to attend a mandatory interview with the Stanley Behrens Foundation Scholarship Review committee in May. The scholarship recipient will be required to attend a scholarship luncheon in May. No late applications will be accepted. We are unable to provide a response to all applicants. Only finalists will be notified. Please contact us at scholarships@uci.edu if you have any questions.

2 STANLEY BEHRENS FOUNDATION TRANSFER STUDENT SCHOLARSHIP APPLICATION Application Deadline: May 5, 2016 (Must be received in the office by 5pm) I. APPLICANT INFORMATION Full Name: Last Name First Name Middle Name Address: Number/Street City State and Zip Code Home Phone Number: ( ) Cell or Alternate Phone Number: ( ) Address: Career Objective: II. EDUCATIONAL BACKGROUND High School(s) Attended: City: Dates: Community College(s) Attended: City: Dates: Major or Intended Major: Degree Objective: Bachelor of Science Bachelor of Arts Bachelor of Fine Arts Career Objective:

3 II. EDUCATIONAL BACKGROUND, CONTINUED Please provide your SAT and/or ACT scores (if applicable): Date: Critical Reading Score/Percentile: Math Score/Percentile: Writing Score/ Percentile: Please provide your SAT II scores (if applicable): Date: Subject: Score/Percentile: If you have taken any Advanced Placement (AP) exams, please provide your scores: Date: Subject: Score: List any honors, awards, or scholarships received: Date: Title: Description:

4 III. ADDITIONAL BACKGROUND INFORMATION List any past or current employment: Position and Duties: Dates: Hours per Week: The Stanley Behrens Foundation is interested in your non-academic talents, interests, hobbies, experiences, etc. Please list your extra-curricular involvement: Organization: Position: Dates: Description of Activities:

5 III. ADDITIONAL BACKGROUND INFORMATION, CONTINUED Please describe one of your talents, special skills, hobbies, or extra-curricular activities that have had a significant impact on your personal development. Tell us why it has had such a profound affect on your development. (You may attach your answer as a separate document) IV. HOUSEHOLD INFORMATION List all members of your household and their relationship to you: Name: Age: Relationship: Estimated combined family income in 2015: (Finalists may be asked to submit copies of their federal tax returns.) How many people were supported by the family s income?

6 IV. HOUSEHOLD INFORMATION, CONTINUED Discuss your interfamily relationship. Who are you closest to and how has that person had an impact on you? How has your interaction with family members or close friends influenced your viewpoints on life? Would you say that your interaction with your family furthered or hindered your educational and personal development? (You may attach your answer as a separate document) V. PERSONAL STATEMENT Applicants are required to submit a personal statement. Your personal statement should be an autobiographical essay that addresses the following: a. What are your educational and career goals? b. Describe the events in your life that have compelled you seek these goals. c. What are your talents, characteristics and experiences that will help you achieve these goals? Your personal statement should be a maximum of 500 words using standard formatting (regular Times New Roman, font size 12, and double-spaced). Please write your response on a separate sheet of paper and attach it to the application. VI. CERTIFICATION - TO BE SIGNED BY ALL APPLICANTS I have read and understand the enclosed information. I affirm that the information which I have provided on this application form and any additional material that I submit related to the financial aid process is complete, accurate and true to the best of my knowledge. Pursuant to the Family Educational Rights and Privacy Act of 1974, as amended (FERPA), I hereby authorize UC Irvine to release the scholarship application information provided by me, as well as other official and unofficial UCI information regarding my academic progress and status, to scholarship donors for the purpose of providing the donors with information on my eligibility as a scholarship recipient. I also understand that furnishing false information may result in revocation of my financial aid or may result in disciplinary action pursuant to the UC Irvine Code of Student Conduct. Applicant's Signature: Date: The State of California requires that you be told the following: Federal student loans are available to most students regardless of income and provide a range of repayment options including income-based repayment plans and loan forgiveness benefits, which other education loans are not required to provide.

7 Accommodations: Upon request, this publication will be made available in alternative formats for people with disabilities. Contact the UCI Disability Services Center; telephone , TDD The campus and all buildings are accessible by wheelchair. Campus Safety: Pursuant to the Federal Jeanne Clery Disclosure of Campus Security Policy and Campus Crime Statistics Act, UCI annually makes available to the public statistics on reported occurrences of criminal activity on and off campus and at UCI Medical Center at Nondiscrimination Policy: The University of California, in accordance with applicable Federal and State law and university policy, does not discriminate on the basis of race, color, national origin, religion, sex, gender identity, pregnancy, physical or mental disability, medical condition (cancer related or genetic characteristics), ancestry, marital status, age, sexual orientation, citizenship, or service in the uniformed services. The university also prohibits sexual harassment, including sexual violence. This nondiscrimination policy covers admission, access, and treatment in university programs and activities. For more information, call