EmailMe Form - 2021 Angel Sanchez, Sr. Undergrad Scholarship

2021 Angel Sanchez, Sr. Undergrad Scholarship

Provided by the Jurupa Valley Adopt a Family Program and made possible by donations.

The Angel Sanchez, Sr. Scholarship program is named after Angel Sanchez, Sr., a World War II veteran and lifelong community servant who is the father of one of our founding members. The Scholarship is open to college Freshmen, Sophomores, or Juniors who have volunteered a minimum of 25 hours and have fulfilled the additional Scholarship Committee requirements. The scholarship is awarded based on need, volunteer performance, and academic achievement.

WE ARE NOT RESPONSIBLE FOR COMPUTER OR TECHNICAL ISSUES. WE RECOMMEND YOU WRITE ANY ESSAYS ON A WORD DOCUMENT AND COPY AND PASTE INTO THE APPROPRIATE FIELD. DO NOT USE THE BACK FUNCTION ON YOUR BROWSER AS YOUR INFORMATION WILL NOT BE SAVED. IF YOU ARE UNABLE TO COMPLETE THE APPLICATION IN ONE SITTING YOU CAN SAVE AND RESUME LATER BY COPYING THE LINK PROVIDED AT THE END OF THE APPLICATION.

Terms and Conditions - Please read before completing this application.

*Maximum scholarship value $1000

The scholarship is open to individuals who have volunteered 25 hours to the program and have fulfilled the additional scholarship committee requirements. The scholarship is awarded based on need, volunteer performance, and academic achievement.

Requirements:

* Applicant must live in the Inland Empire*.
* Applicant must have accumulated a minimum of 25 volunteer hours with the Jurupa Valley Adopt a Family program in the year prior to applying.
* Applicant must provide a copy of the Letter of Attendance from their accredited school to the Scholarship Committee by June 1st. Checks will be issued directly to the institution on behalf of the recipient.
* Applicants must have a cumulative GPA of 2.5.
*Applications must be submitted no later than April 15, 2021

* Cities in the Inland Empire include: Banning - Beaumont - Blythe - Calimesa - Canyon Lake - Coachella - Corona - Desert Hot Sprints - Eastvale - Hemet - Indian Wells - Indio - Jurupa Valley - La Quinta - Lake Elsinore - Menifee - Moreno Valley - Murrieta - Norco - Palm Desert - Palm Springs - Perris - Rancho Mirage - Riverside - San Jacinto - Temecula - Wildomar - Adelanto - Apple Valley - Barstow - Big Bear Lake - Chino - Chino Hills - Colton - Fontana - Grand Terrace - Hesperia - Highland - Loma Linda - Montclair - Needles - Ontario - Rancho Cucamonga - Redlands - Rialto - San Bernardino - Twentynine Palms - Upland - Victorville - Yucaipa - Yucca Valley - adjoining unincorporated areas.
Scholarship Application Type *
Eligibility Checklist *
I live or attend school in the Inland Empire*
*
I volunteered 25 or more hours with the JVAAF program in 2020
*
I meet all the eligibility requirements listed in the Terms and Conditions
Personal Information
Name *
First Middle Last
Date of Birth *
MM / DD / YYYY
Place of Birth *
Email *
Phone *
### - ### - ####
Cell Phone
### - ### - ####
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Mailing Address (If Different)

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Gender
Male
Female
Are you married or do receive financial support from someone other than your parents/guardians? *
Are you the primary source of financial support for any children? *
Will you be the first person in your immediate family to graduate with a four year degree? *
Citizenship
Are you currently a United States Citizen? *
If not please indicate your status? *
If you were not born an American Citizen, but are a Naturalized American Citizen, give date, place (Office or Court where Naturalization occurred) and Naturalization Number. If naturalized under the Child Citizenship Act of 2000, please include your parent(s)’ naturalization information.
Date of Naturalization (If Applicable)
MM / DD / YYYY
Place
Number
College Information
What is your planned major? *
College Currently Attending
University of attendance 2020-2021
For which term will you be seeking admission? *
Where will you be living? *
University Information
University Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Estimated Graduation Date *
MM / DD / YYYY
Admission Counselor's Name *
University Phone *
### - ### - ####
Academics
You must submit a copy of your current University transcript. The transcript must include up to date quarter/semester grades.
Please upload a copy of your most recent transcripts dated January 1, 2021 or later. A copy may be mailed in (see mailing instructions below). Applications will not be reviewed until transcripts are received. All transcripts must be received by April 1,2020
Cumulative GPA *
Please list any courses taken (up to 10)
Does your school offer an ROTC program? *
Did you participate in an ROTC program?
If your records have been expunged pursuant to applicable law, you are not required to answer yes to the following questions. If you are unsure whether to answer yes, we strongly suggest that you answer yes and fully disclose all incidents to avoid any risk of revocation of a scholarship offer.
Are you currently or have you ever been charged with or subject to disciplinary action for scholastic or any other type of misconduct at any educational institution? *
Yes
No
If yes, please explain.
Have you ever been charged with a violation of the law which resulted in, or if still pending could result in, probation, community service, a jail sentence, or the revocation or suspension of your driver’s license (including traffic violations which resulted in a fine of $200 or more?) *
Yes
No
If yes, please explain.
Leadership and Extracurricular Activities
List your principle leadership and extracurricular activities in the order of importance to you. You may upload a separate document to list more than 9 activities.
Do you have family obligations that keep you from participating in extracurricular activities? *
No
Yes, I have to work to supplement family income.
Yes, I provide primary care for family member(s).
Activity 1

Organization

Hours Per Week

Weeks Per Year

Position Held

Responsibilities

Honors Received/Letters Earned

State the name of the organization, hours-per-week commitment, leadership role, and responsibilities held in that role. Examples include, but are not limited to, student government, publications, debate, orchestra/band, varsity athletics, church groups, performing arts, service programs, etc.
Grade Level
Please indicate all grade levels you participated in this activity. Hold CTRL key down to choose more than one grade.
Activity 2

Organization

Hours Per Week

Weeks Per Year

Position Held

Responsibilities

Honors Received/Letters Earned

State the name of the organization, hours-per-week commitment, leadership role, and responsibilities held in that role. Examples include, but are not limited to, student government, publications, debate, orchestra/band, varsity athletics, church groups, performing arts, service programs, etc.
Grade Level
Please indicate all grade levels you participated in this activity. Hold CTRL key down to choose more than one grade.
Activity 3

Organization

Hours Per Week

Weeks Per Year

Position Held

Responsibilities

Honors Received/Letters Earned

State the name of the organization, hours-per-week commitment, leadership role, and responsibilities held in that role. Examples include, but are not limited to, student government, publications, debate, orchestra/band, varsity athletics, church groups, performing arts, service programs, etc.
Grade Level
Please indicate all grade levels you participated in this activity. Hold CTRL key down to choose more than one grade.
Activity 4

Organization

Hours Per Week

Weeks Per Year

Position Held

Responsibilities

Honors Received/Letters Earned

State the name of the organization, hours-per-week commitment, leadership role, and responsibilities held in that role. Examples include, but are not limited to, student government, publications, debate, orchestra/band, varsity athletics, church groups, performing arts, service programs, etc.
Grade Level
Please indicate all grade levels you participated in this activity. Hold CTRL key down to choose more than one grade.
Activity 5

Organization

Hours Per Week

Weeks Per Year

Position Held

Responsibilities

Honors Received/Letters Earned

State the name of the organization, hours-per-week commitment, leadership role, and responsibilities held in that role. Examples include, but are not limited to, student government, publications, debate, orchestra/band, varsity athletics, church groups, performing arts, service programs, etc.
Grade Level
Please indicate all grade levels you participated in this activity. Hold CTRL key down to choose more than one grade.
Activity 6

Organization

Hours Per Week

Weeks Per Year

Position Held

Responsibilities

Honors Received/Letters Earned

State the name of the organization, hours-per-week commitment, leadership role, and responsibilities held in that role. Examples include, but are not limited to, student government, publications, debate, orchestra/band, varsity athletics, church groups, performing arts, service programs, etc.
Grade Level
Please indicate all grade levels you participated in this activity. Hold CTRL key down to choose more than one grade.
Activity 7

Organization

Hours Per Week

Weeks Per Year

Position Held

Responsibilities

Honors Received/Letters Earned

State the name of the organization, hours-per-week commitment, leadership role, and responsibilities held in that role. Examples include, but are not limited to, student government, publications, debate, orchestra/band, varsity athletics, church groups, performing arts, service programs, etc.
Grade Level
Please indicate all grade levels you participated in this activity. Hold CTRL key down to choose more than one grade.
Activity 8

Organization

Hours Per Week

Weeks Per Year

Position Held

Responsibilities

Honors Received/Letters Earned

State the name of the organization, hours-per-week commitment, leadership role, and responsibilities held in that role. Examples include, but are not limited to, student government, publications, debate, orchestra/band, varsity athletics, church groups, performing arts, service programs, etc.
Grade Level
Please indicate all grade levels you participated in this activity. Hold CTRL key down to choose more than one grade.
Activity 9

Organization

Hours Per Week

Weeks Per Year

Position Held

Responsibilities

Honors Received/Letters Earned

State the name of the organization, hours-per-week commitment, leadership role, and responsibilities held in that role. Examples include, but are not limited to, student government, publications, debate, orchestra/band, varsity athletics, church groups, performing arts, service programs, etc.
Grade Level
Please indicate all grade levels you participated in this activity. Hold CTRL key down to choose more than one grade.
If more than 9 activities please lists additional activities on a separate form and upload here.
Non-profit service hours - Based on the activities listed above or on your supplemental activities form please list the organization and number of hours you have donated between grades 9 and 12. This is used to summarize your volunteer hours and does not replace the activities information above. Please complete the activities section above AND the summary information included here.

Organization Total Hours

JV Adopt a Family Program

Non-profit 2

Non-profit 3

Non-profit 4

Non-profit 5
Award/Honors
List scholastic, extracurricular, and civic honors and awards received during grades 9 through 12. Please do not abbreviate names of awards, as we may not understand their meanings.
Honor/Award Grade Level

Award/Honor 1

Award/Honor 2

Award/Honor 3

Award/Honor 4

Award/Honor 5

Award/Honor 6

Award/Honor 7

Award/Honor 8
If more than 8 Awards/Honors please list on a separate form and upload here.
Family Information
Parents should assist with completing of this information.

Parent(s): Complete the financial information section based on your 2020 IRS 1040. If taxes have not been filed for 2020 please use estimates.

If parents are divorced or separated, answer the questions for the parent the applicant lived with the most in the past 12 months. If the applicant lived with both parents an equal number of days in the past 12 months, count the parent who provided the greatest amount of support, financial as well as material. Material support includes cars, clothing, medical and dental payments, etc. If that parent has remarried, the stepparent's information must be included.
With whom does the applicant live with? *
If "Other" please complete
1. Father or Legal Guardian Name *
First Last
Father or Legal Guardian Occupation *
Father or Legal Guardian Education *
2. Mother or Legal Guardian Name
First Last
Mother or Legal Guardian Occupation
Mother or Legal Guardian Education
Please indicate your family’s gross income for the most recent tax year. Include both taxed and untaxed income. *
Number of people in family, not including parents, who will receive the majority of parental support between Sept. 1, 2021, and Aug. 31, 2022. Include dependent children and others, e.g. dependent grandparent, living in household who receive more than half their support from parents. *
Number of dependent children, including applicant, as defined above, attending college during academic year 2021-2022 on at least a half-time basis. *
If you have extenuating financial circumstances, please explain in 200 words or less.
Employment
Please list any employment you have had
Employment 1

Company

Hours Per Week

Weeks Per Year

Position Held

Responsibilities

Dates Employed

State the name of the company, hours per week and weeks per year you worked, position held and responsibilities held in that role.
Employment 2

Company

Hours Per Week

Weeks Per Year

Position Held

Responsibilities

Dates Employed

State the name of the company, hours per week and weeks per year you worked, position held and responsibilities held in that role.
Employment 3

Company

Hours Per Week

Weeks Per Year

Position Held

Responsibilities

Dates Employed

State the name of the company, hours per week and weeks per year you worked, position held and responsibilities held in that role.
Essay Questions
Complete the essay sections below. These essays will be used by the committee to gain a better understanding of who you are.
How has participation in the Adopt a Family program impacted your life? Maximum of 250 words. *
Briefly describe your long- and short-term goals. Maximum of 250 words. *
Optional - Pick an experience from your own life and explain how it has influenced your development. Maximum of 250 words.
Applications must be submitted no later than April 15, 2021.

By signing this application, you agree, if asked, to provide information that will verify the accuracy of your completed form. If you purposely give false or misleading information, you will be disqualified from this contest. You agree to the use of your name and information contained within the application for advertising, promotional and publicity purposes without consent or compensation.
Do you understand and agree to the terms listed above? *
Yes, I understand and agree to the terms listed above.
I understand that failure to meet any of the requirements of this application, including providing required documentation by the dates due will result in revocation of scholarship offer. *
Yes, I understand and agree to the terms listed above.
Date Time *
MM / DD / YYYY
Electronic Signature - Please place your name here. This will serve as an electronic signature verifying that you have completed this application with accurate information and that you understand the terms and conditions of the scholarship program. *
Mail Instructions
Items can be mailed in to
Jurupa Valley Adopt a Family
PO Box 3697
Riverside, CA 92519

Organization
Hours Per Week
Weeks Per Year
Position Held
Responsibilities
Honors Received/Letters Earned

	Organization	Total Hours
JV Adopt a Family Program
Non-profit 2
Non-profit 3
Non-profit 4
Non-profit 5

	Honor/Award	Grade Level
Award/Honor 1
Award/Honor 2
Award/Honor 3
Award/Honor 4
Award/Honor 5
Award/Honor 6
Award/Honor 7
Award/Honor 8

Company
Hours Per Week
Weeks Per Year
Position Held
Responsibilities
Dates Employed

Personal Information

Citizenship

College Information

University Information

Academics

Leadership and Extracurricular Activities

Award/Honors

Family Information

Employment

Essay Questions

Mail Instructions