Fillable Rotary Club of San Mateo Scholarship Application 2020 (College of San Mateo)

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Rotary Club of San Mateo Scholarship Application 2020 (College of San Mateo)

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1
Rotary Club of San Mateo
Scholarship Application – 2020
for students who wish to attend a four-year university.
Deadline for submission to CSM Financial Aid Office, ATTENTION:
Karen Chadwick (chadwick@smccd.edu):
March 5, 2020 by 12:00pm (noon)
PLEASE PRINT
Name___________________________________________________________________
Home Address ____________________________________________________________
____________________________________________________________
Phone (home)___________________________(cell)_____________________________
Email___________________________________________________________________
High School (must have attended high school in city of San Mateo)
_______________________________________________________________________
GPA weighted______unweighted______ SAT Score____________
ACT Score______________
References
Counselor Phone
_________________________________________ ________________________
Teacher Phone
_________________________________________ _______________________
Non-School Acquaintance Phone
(neighbor, work/volunteering, sports)
_______________________________________ ________________________
List Extra-Curricular and Volunteer Activities:
(Attach additional sheet/resume if necessary)
_______________________________________________________________________
2
_______________________________________________________________________
List Recent Work Experience
Employer Dates Worked Salary
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
School (s) you hope to attend:
A B
Name___________________________________________________________________
Tuition_________________________________________________________________
Room/Board_____________________________________________________________
Books/Fees______________________________________________________________
Travel__________________________________________________________________
Other__________________________________________________________________
Total Cost _____________________________________________________________
==============================================================
Family: Savings for School $______________________________________________
Monthly amount (not from savings) to assist with school expenses $_______________
Student Savings $___________________
Scholarships Received $___________________
Total Funds You Have $___________________
Amount Needed $___________________
Did you complete the FAFSA?
Yes_______ No_______
Did you complete the Cal Dream Act? Yes_______ No_______
Tax returns for 2018/2019; Please attach
Expected Family Contribution (EFC) $___________
If yes, Please attach Student Aid
Report or California Aid Report.
3
List scholarships for which you have applied or already received; list amounts:
______________________________________________________________________
______________________________________________________________________
Confidential Financial Statement
Father’s Name & Occupation______________________________________________
Monthly Income $________________________________________________________
Mother’s Name & Occupation _____________________________________________
Monthly Income $________________________________________________________
Savings $__________________________________
Other Monthly Income:
Social Security________________
Child Support/Alimony_________ Rental Properties__________
Own Home? Yes_____ No_____ Value $________________
Amount Owed on Mortgage $________________
Monthly Mortgage Payment $________________
If you do not own, monthly rent $________________
Special Financial Problems--Large debts, unemployment, medical expenses, etc.)
I agree that Rotary Club scholarship representatives may meet with the applicant for interviews,
may contact teachers and references, and use photos of the applicant for Rotary publicity.
The above statements are true to the best of my knowledge.
Signatures of student and parent or guardian
Student ___________________________________________________ Date__________
Parent/Guardian_____________________________________________Date__________
4
Personal statement: why you plan to attend college and what are your
goals?
__________________________________________________________
R
emember to attach copies of FAFSA and/or federal tax returns for
either 2018 or 2019.
T
hank you!
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Rotary Club of San Mateo Scholarship Application 2020 (College of San Mateo)

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Completed 1 March 2021

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