2017 - 2018 Community College Real Estate Endowment
Fund Scholarship Application
Application Filing Period: September 1, 2017 – April 30, 2018
New Applicant Renewal Applicant
1. Name:
Middle Initial
2. Student ID Number:
3. Home Address:
4. Telephone Number:
( )
5. Gender:
6. Estimated number of real estate units to be enrolled/completed:
Fall 2017
Spring 2018
Summer 2018
7. College to be attended during 2017-2018 academic year:
8. Major:
9. Educational Objective: AA/AS Real Estate Certificate
10. Estimated Completion Date for above:
11. Do you anticipate transferring to a four-year college upon completion of your educational objective above?
Yes No
If yes, give name of the four year college (if known):
12. Ethnic Identity (this information is voluntary):
1. Native American 3. Hispanic 5. White
2. African-American 4. Asian
6. Other:
13. Have you completed at least one three-unit, college-level real estate course with a "C" (2.0) average or higher?
Yes No
14. Financial Information: All applicants must complete and submit the 2017-2018 Free Application for Federal Student Aid (FAFSA)
to the college’s financial aid office prior to applying for this scholarship.
15. Letter of Recommendation: A letter of recommendation is required from a Real Estate Department Instructor. Please attach the
letter to this application. Also, attach a copy of your current semester Real Estate course enrollment verification and a copy of
verification of completion of your first 3-unit Real Estate course.
16. Have you ever been convicted of a misdemeanor or felony? Yes No
(You may omit traffic citations which do not constitute a misdemeanor or felony.)
17. Are there criminal charges pending against you at this time? Yes No
18. Have you ever had a denied, suspended, restricted or revoked business or professional license (including real estate) in
California or any other state?
Yes No
If you answered No to questions 16, 17, and 18, skip to the Certification section. If you answered Yes to any of these questions, you will
have to submit a written explanation/documentation to the California Department of Real Estate. The Department of Real Estate will review
your explanation/documentation and determine whether you are eligible for the scholarship. If all scholarship funds have been exhausted
prior to a returned favorable response from the Department of Real Estate, you may not be funded for this year’s scholarship. Be advised
that these questions also appear on the Real Estate Sales License application and a positive response could cause the applicant to be
denied a sales license upon application to the Department of Real Estate.
All of the information on this form is true and complete to the best of my knowledge. I hereby give the community college permission to
release this information to any agency necessary for the processing or funding of my aid application. In completing this application, if I have
indicated an intention to transfer to any California State University (CSU) campus at a future date, I give permission to the California
Community Colleges Chancellor's Office to release my name and address to the CSU system so that I may receive information on the CSU
Real Estate Scholarship Program.
Student Signature
Parent Signature (Dependent Students Only)
California Information Privacy Act
State and federal laws protect an individual’s right to privacy regarding information pertaining to oneself. The California Information Practices Act of 1977
requires the following information be provided to financial aid applicants who are asked to supply information about themselves. The principal purpose for
requesting information on this form is to determine your eligibility for financial aid. The Chancellor’s Office policy and the policy of the community college to
which you are applying for aid authorize maintenance of this information. Failure to provide such information will delay and may even prevent your receipt
of financial assistance. This form’s information may be transmitted to other state agencies and the federal government if required by law. Individuals have
the right of access to records established from information furnished on this form as it pertains to them.
The officials responsible for maintaining the information contained on this form are the financial aid administrators at the institutions to which you are applying
for financial aid. The SSN may be used to verify your identity under record keeping systems established prior to January 1, 1975. If your college requires
you to provide an SSN and you have questions, you should ask the financial aid officer at your college for further information. The Chancellor’s Office and
the California community colleges, in compliance with federal and state laws, do not discriminate on the basis of race, religion, color, national origin, gender,
age, disability, medical condition, sexual orientation, domestic partnership or any other legally protected basis. Inquiries regarding these policies may be
directed to the financial aid office of the college to which you are applying.
After completion, submit application and supporting documentation to the
campus Financial Aid Office for processing
click to sign
click to edit
click to sign
click to edit