Valencia College
The Michael Jon
FOUNDATION SCHOLARSHIP APPLICATION
2011-12
Dreams and Passions
� New application ____For summer semester enrollment
Scholarship
(Due April 20, 2012)
Name ______________________________________________________VID# or SS# ___________________________ Address___________________________________________________________________________________________ Street
City
County
State
ZIP Code
Home phone ____________ Work phone ___________ Cell phone or pager _____________ Email- ________________
Academic Information: Degree____________ Major____________________ GPA________
Date you submitted the FAFSA __/__/___
High School Attended_____________________ Location________________High School Graduation Date__/__/__ Current Employer _______________________ Does your employer offer tuition reimbursement? ___yes ___no If you would like to be considered for a scholarship based on the following criteria please check off any of the boxes that apply to you. Please remember that this section is completely optional: I I _I _I _I _ _
am registered with the Office of Disability Services am a single parent completed Tech Prep courses while in high school took Dual Enrollment courses while in high school participated in community service
Ethnicity__________________ Gender___________________ Age_______
Please attach a brief personal statement which should include the following two (2) points: 1) Tell about yourself and what you want your future to look like. 2) Tell us about your interests and your passion for cooking. Please check off the statements below to indicate your understanding: � I give Valencia permission to provide my scholarship donor with a report of my academic performance, copies of my academic transcripts and to share information from my personal statement. � I understand that no funds will be released for my use until I have provided Financial Aid Services with a thank you note for my scholarship donor. � I will provide an update on my academic, personal and professional progress at yearend to share with my donor. � I understand that this application is for scholarships selected by Valencia’s scholarship committee but may also be used to identify candidates for donor-selected scholarships. � I will attend a donor recognition event or a media announcement at the request of the donor or the college foundation. ________________________________________________________ Signature of student
___________ Date
This form should be submitted to the Valencia Foundation directly. foundation@valenciacollege.edu
Please Fax to 407/582-3156 Or mail to: Valencia Foundation 190 S. Orange Avenue Orlando, FL 32801