AVHCC Scholarship 2017

Antelope Valley Hispanic Chamber of Commerce
Excellence for Education Scholarship Awards Application
1.DEADLINE for scholarship applications is April 20, 2017. (no exceptions)

2.Refer to criteria below for eligibility requirements.
3.Refer to application process below for a list of the supporting documents needed (i.e., evidence of GPA.) Incomplete
applications will not be considered.
4.Submissions should be e-mailed to office@avhcc.org or delivered to AVHCC 819 E Ave Q9 Palmdale CA 93550. All
submissions should be printed.
5.The recipients will be notified by phone or email.
6.If you have any questions about the application, please e-mail or call (Sylvia S. Duarte) 661-538-0607
NOTE: Scholarship funds will be awarded to the students institution, upon evidence of registration in classes.
This includes student identification number and correct address of school.
Award Components: $250 -$500 with a range to be determined by the number of sponsors
Criteria:
1.Applicant must be graduating in the Antelope Valley High Schools Senior Class in 2017
2.GPA 2.5 to 3.0
3.Performance Arts Students (music) encouraged to apply
4.Applicant must demonstrate a positive impact. We will be looking at Academics, school and community
involvement, employment and family hardship.
Components of Application
A. The following items must be attached to this application in order for the application to qualify to be reviewed
by the scholarship committee.
Circle YES or NO be sure you have attached each item as required.
YES NO
3 Letters of recommendation.
YES NO Proof of college acceptance or current student enrollment must be produced, if selected
as recipient. Scholarship will go directly to institution to be applied to tuition costs.
YES NO Most recent high school transcript.
YES NO Have you served your community in anyway? If so explain in your essay.
YES NO Attach a typed essay 12 font double spaced:
On how does this scholarship help you and how do you have a positive impact
in your community, school, family, etc.?
Scholarship Awards Application
Name: Last: ______________________________First: _______________________Middle Initial:______
Home Address: ________________________ City: ______________________ Zip Code: ________
Home Phone Number: _____________________________ Cell: _____________________________
Date of Birth: Month: ________Day: _______Year:________
Social Security Number: ________/_______/_________
Email Address: __________________________________
(For Statistical Purposes Only)
Gender: Male Female Transgender Other
Ethnicity Alaskan Native American Indian Asian, Pacific Islander or East Indian
African American Hispanic/Latino White Other
Parent or Guardian:
Name: Last: ______________________________First: _______________________Middle Initial:______
Home Phone Number: _____________________________ Cell: _____________________________
Relationship to Applicant: ___________________________
High School Attending
School Name: ______________________________ Graduating Date: _______/_______/_______
City: ______________________________ State: _________ Telephone: _____________________
Counselors Name: ________________________________ Telephone: _____________________
Overall GPA: ___________________ (Make Sure To Attach Official Transcript)
School You Will Be Attending:
School Name: _______________________________________
School Address: ________________________ City: ______________________ Zip Code: ________
4-Yr College Community College

Vocational/Technical School Other
What is your course Major: _____________________________Anticipated Date of Graduation: ______/_____/_____

Anticipated Degree Associate BA/BS Certificate/License
List all community involvement, such as awards and honors that you have participated in, in the past four
years. Include all activities such as sports, music, and tutoring and volunteer hours. (Please add additional
sheets if needed)
Activity: ____________________ No. of years: ________Special Awards/Honors ________________________
Office held such as President, VP etc.________________________________
Office held such as President, VP etc._________________________________
List goals and aspirations

What are your educational and professional goals and objectives?
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Please describe the reason for your financial need and how will you use this award to supplement
your educational goals. (Attach additional sheets if necessary)
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
STATEMENT OF ACCURACY
I hereby affirm that all the above stated information provided by me is true and correct to the best of my knowledge. I
also consent that my picture may be taken and used for any purpose deemed necessary to promote the Antelope Valley
Hispanic Chamber Excellence for Scholarship program.
I hereby understand that if chosen as a scholarship winner, I must provide evidence of enrollment/registration before
scholarship funds can be awarded. They will be presented directly to me or the institution.
Signature of scholarship applicant: _________________________________ Date: ________________________
Counselors Signature: ___________________________________________ Date: ________________________
Parent or Guardians Signature: ____________________________________ Date: ________________________
REMEMBER
The Deadline is Friday, April 20, 2017 by 5:00p. Applications received after 5:00pm will not be considered.
The Education for Excellence Scholarship Committees purpose is, in part, to have a positive impact
on all who come in contact with them.
Dont forget to include your essay. In order to be considered you must have all required paper work
turned in with application.
Return application with attachments to the:

Education for Excellence Committee (Attention Sylvia S. Duarte)
819 E Avenue Q9
Palmdale, CA 93550
Recipients will be selected by the Excellence for Education Committee. Scholarships will be issued after receiving
proof of enrollment in a college or a technical school. Confirmation of college/technical school enrollment must be
received by October 31, 2017 or sooner to receive the scholarship. Certificates will be presented at the Schools
Award presentations. The Education for Excellence Scholarship Committee will be hosting their own presentation
of awards, date and time to be determined.

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Antelope Valley Hispanic Chamber of Commerce

Excellence for Education Scholarship Awards Application

1.DEADLINE for scholarship applications is April 20, 2017. (no exceptions)

YES NO Most recent high school transcript.

Name: Last: ______________________________First: _______________________Middle Initial:______

Home Address: ________________________ City: ______________________ Zip Code: ________

Home Phone Number: _____________________________ Cell: _____________________________

Date of Birth: Month: ________Day: _______Year:________

Social Security Number: ________/_______/_________

Email Address: __________________________________

(For Statistical Purposes Only)

Gender: Male Female Transgender Other

Name: Last: ______________________________First: _______________________Middle Initial:______

Home Phone Number: _____________________________ Cell: _____________________________

Relationship to Applicant: ___________________________

High School Attending

School Name: ______________________________ Graduating Date: _______/_______/_______

City: ______________________________ State: _________ Telephone: _____________________

Counselors Name: ________________________________ Telephone: _____________________

Overall GPA: ___________________ (Make Sure To Attach Official Transcript)

School You Will Be Attending:

School Name: _______________________________________

School Address: ________________________ City: ______________________ Zip Code: ________

4-Yr College Community College

What is your course Major: _____________________________Anticipated Date of Graduation: ______/_____/_____

Activity: ____________________ No. of years: ________Special Awards/Honors ________________________

Office held such as President, VP etc.________________________________

Activity: ____________________ No. of years: ________Special Awards/Honors ________________________

Office held such as President, VP etc._________________________________

Activity: ____________________ No. of years: ________Special Awards/Honors ________________________

Office held such as President, VP etc._________________________________

Activity: ____________________ No. of years: ________Special Awards/Honors ________________________

Office held such as President, VP etc._________________________________

List goals and aspirations

Signature of scholarship applicant: _________________________________ Date: ________________________

Counselors Signature: ___________________________________________ Date: ________________________

Parent or Guardians Signature: ____________________________________ Date: ________________________

Return application with attachments to the:

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Name: Last: ______________First: _Middle Initial:

Home Address: __________ City: Zip Code:

Home Phone Number: _ Cell: _

Date of Birth: Month: ____Day: _Year:______

Social Security Number: ____/_/_______

Name: Last: ______________First: _Middle Initial:

Home Phone Number: _ Cell: _

School Name: __________________________ Graduating Date: _/_/___

City: __________________________ State: _ Telephone: _________________

Counselors Name: ____________ Telephone: _

School Address: __________ City: Zip Code:

What is your course Major: _________________________Anticipated Date of Graduation: /_/___

Activity: No. of years: Special Awards/Honors ____

Activity: No. of years: Special Awards/Honors ____

Activity: No. of years: Special Awards/Honors ____

Activity: No. of years: Special Awards/Honors ____

Signature of scholarship applicant: _________ Date:

Counselors Signature: ___________________ Date:

Parent or Guardians Signature: ____________ Date: