2015 Undergraduate NHBG Education Fund Scholarship Application

Transcription

1 2015 Undergraduate NHBG Education Fund Scholarship Application About The NHBG: About The Scholarship: The National Hispanic Business Group (NHBG) was founded in 1985 by a prominent group of Hispanic entrepreneurs with the objective of advancing the business goals and opportunities of its members in the public and private sectors while supporting positive social change and community involvement. As an organization of business leaders we seek to assist Hispanic/Latino students who we believe are the future generation of NHBG members. Through our scholarship program, the NHBG provides financial assistance to Hispanic-Latino students who are enrolled in a College or University on a full time basis and pursuing an undergraduate degree. The $5, scholarship award is applied towards the student s yearly tuition and disbursed on a semester basis. Payments are made directly to the College or University once proof is provided that the student has completed his/her course work and is registered as a full-time student for the following semester as an undergraduate student. Scholarship recipients will be notified during the month of June Scholarships will be awarded at NHBG s Annual Gala Dinner Dance on Thursday, July 16, Eligibility: To be eligible for the scholarship, the student must: Be of Hispanic-Latino heritage; Be a U.S. citizen or a permanent U.S. resident; Live within the Tri-State Region Attend an accredited college/university on a full-time basis; Have a minimum grade point average of 3.0 on a 4.0 scale; Demonstrate a financial need for assistance. Deadline: The Deadline for submitting a completed application is Wednesday, June 3 rd, All applications should be sent to: Ms. Jacqueline Pina The National Hispanic Business Group 880 Third Avenue Suite 1202 New York, NY ATTN: Scholarship Committee Questions: If you have any questions regarding the scholarship application or eligibility requirements please contact: Jacqueline Pina at of 7

2 Student Information Name: Mailing Address: Last First MI Number Street Apt. No. City State Zip Code Phone: ( ) Area Code Number Social Security No.: Citizenship: U.S. Citizen Eligible Non-Citizen Alien Reg. No. College Information (Please List all Colleges/University Attended) Note: You must include an official copy of your transcript for any Colleges/Universities listed below. College Name: Dates Attended: Curriculum: Name Address State Date to Date Major Minor (if any) GPA Total Credits Accumulated Credits Required for Degree Expected Graduation Date College Name: Dates Attended: Name Address State Date to Date Curriculum: Major Minor (if any) Credits Completed GPA (provide copy of transcript) 2 of 7

3 College Information (continued) College Name: Dates Attended: Name Address State Date to Date Curriculum: Major Minor (if any) Credits Completed GPA (provide copy of transcript) Activities/Awards Please list any community, (i.e. civic or church group, high schools or college) activities that you have been involved with or any honors or awards you have received. Use additional sheets of paper (if needed) to fully describe your participation. Name of Activity/Award Summary of Activity/Award Date of Participation or Award 3 of 7

4 Employment Please indicate current and previous employment history. Company Responsibilities Dates Hours/Week Do you expect to work during the academic year? ( Check whichever applies) Full Time Part Time College Work Study No Financial Aid Information As of today s date, have you received any financial assistance? ( Check whichever applies) No Yes If yes, please provide a description of the benefit, the amount and the benefit year (e.g. Pell Grant). Benefit Amount Benefit Year Please include a copy of your latest award letter for the current or upcoming semester. 4 of 7

5 Financial Statement Marital Status: Single Married Separated/Divorced Number of Dependents: Please complete the following for EACH dependent (if any): Name Age Does He or She Live with you? Have you received (or will you receive) any financial support from your employer, government, foundations, family or any other outside source during the 2015 term? If yes, please specify the source and the amount of support: Source of Support Amount 5 of 7

6 Financial Resources Please complete the following: Type 2015 Expected 2016 Wages Other Income (specify) Other Income (specify) Total 6 of 7

7 Essay On a separate sheet, please include a typed essay (double-space 500 words or less) that addresses the following issues: Explain how a scholarship will help you attain your career plans and goals. If you achieve these goals, what would you contribute to the Hispanic community? What facts, characteristics and qualifications should The NHBG be aware of when considering your application for scholarship? Signature and Certification Please read the following statement and sign the application as indicated below. 1. I hereby certify that to the best of my knowledge the information provided on this application is true. 2. I hereby give permission to the Scholarship Committee of the National Hispanic Business Group to have access to my college transcripts. 3. If I am an award recipient, I agree to: Attend the award ceremony scheduled for Thursday, July 16 th, 2015 in Manhattan, New York; Maintain full-time registration status during all semesters following receipt of my award (we may require proof of full-time registration status); Maintain a minimum grade point average of 3.0 on a 4.0 scale during the remaining semesters of my College term; Assist the NHBG with any administrative duties (during semester breaks), i.e. mailing out promotional materials at prevailing wages on an as needed basis. If I should fail to meet any of the above-mentioned requirements, this Scholarship may be terminated upon written notice at the sole discretion of The NHBG. X Signed Dated Before you submit your application: Is the application complete? Did you include an official copy of your transcript? Did you request transcripts from all the schools you previously attended? Did you attach the personal essay (type-written, double space 500 words or less)? Please provide a photo of yourself. Did you complete and attach the Financial Disclosure Statement? Did you include your sealed recommendation? Did you read and sign the signature and certification section? Failure to comply with any of the above may result is a denial of your application. 7 of 7