CCE/AFT Local #4522 Scholarship Application 2020-2021 1

SCHOLARSHIP ELIGIBILITY -HIGH SCHOOL SENIORS AND CONTINUTING COLLEGE STUDENTS

• The Palomar College Council of Classified Employees CCE/AFT Local #4522 Scholarship Program offers scholarships to graduating high school seniors and continuing college students who are children, dependents, members, spouses or domestic partners of CCE/AFT Local #4522 members in good standing, or who are children or dependents of retired or deceased CCE/AFT Local #4522 members.

• Scholarships are available to graduating high school seniors and continuing college students planning to attend community college, trade or technical school, four-year college or university, or art school. The award amounts for the 2020-2021 academic year will be a minimum of $500 and a maximum of $2000. The award amount may vary based on the number of applicants, educational plan and program budget. Students who have received this scholarship for two years are not eligible to apply.

• Awards are based on the following criteria:

o Completion of Scholarship Application

o Minimum 2.5 Grade Point Average

o Required essay

o Proof of member dependency. Applicants must be listed as a dependent on their parents' or guardians’ 2018 1040 tax return to be eligible for a scholarship.

• All completed applications must be postmarked no later than June 30, 2020. All applicants will receive notice of their status by July 31, 2020.

Email completed application to: patti@palomarcceaft.org

• Applications may be obtained at www.palomarcceaft.org

CCE/AFT Local #4522 Scholarship Application 2020-2021 2

APPLICATION REQUIREMENTS AND CHECK LIST

1. 2020-2021 Scholarship Application: The application form must be complete and all requirements must be met to be considered. Applications without all of the components listed below will not be considered. Do not send any of the components separately.

2. Unofficial transcript*: Submit your most recent unofficial high school or college transcript. A minimum 2.5 Grade Point Average is required. *Due to the current pandemic crisis, unofficial transcripts are acceptable.

3. Essay: In the spirit of Union activism, address a social justice problem and your role in solving it. Your essay must be typed, doubled-spaced, and titled. Essay should not exceed 500 words.

4. Member verification form: The Membership Verification Form must be completed by the union member, signed by both union member and applicant, and submitted with the application.

5. Proof of Dependency: Submit page 1 of your parents’ 2018 1040 Tax Return to verify your dependent status. Please black out all social security numbers.

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CCE/AFT LOCAL #4522 SCHOLARSHIP APPLICATIONRead all instructions carefully before completing the application.

Applicant Information

___________________________________________________________________________________ Name Age

___________________________________________________________________________________ Home Address

____________________________________________________________________________________ City State Zip

____________________________________________________________________________________ Phone Email

____________________________________________________________________________________ Date of Birth

Educational Background

____________________________________________________________________________________ Name of High School or College (for continuing college students) Anticipated Graduation Date

____________________________________________________________________________________ Address of School

____________________________________________________________________________________ City State Zip

GPA (unofficial transcript required)

Weighted GPA ______________________

Extra-Curricular Activities- include Sports, Clubs, Volunteer/Community Service, work and others

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

CCE/AFT Local #4522 Scholarship Application 2020-2021

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Family Information-*for dependents only

___________________________________________________________________________________ Father’s Name Age or Date of Birth

___________________________________________________________________________________ Mother’s Name Age or Date of Birth

____________________________________________________________________________________ Guardian’s Name Age or Date of Birth

____________________________________________________________________________________ Address of Parent/Guardian

____________________________________________________________________________________ Phone Number of Parent/Guardian

Union Membership (please check one)

Guardian

Guardian

Current member of CCE/AFT Local #4522

Mother Father

Retired member of CCE/AFT Local #4522

Mother Father

Deceased member of CCE/AFT Local #4522

Mother Father Guardian

____________________________________________________________________________________ Name of current, retired or *deceased member *Deceased date of death if applicable

Future Educational Plans

In Fall 2020, I plan to attend:

Community College Trade or Technical School Four Year College or University Art School

List the name of the college you plan to attend or colleges you have applied to:

_____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________CCE/AFT Local #4522 Scholarship Application 2020-2021

Spouse Self

CCE/AFT Local #4522 Scholarship Application 2020-2021 5

MEMBERSHIP VERIFICATION FORMRead all instructions carefully before completing the application.

This form MUST be completed by both the applicant and the CCE/AFT Local #4522 Union Member.

The membership status will be verified by the CCE/AFT Local #4522 Executive Council as part of the scholarship application review process.

___________________________________________________________________________________ Scholarship Applicant Name Application Year

___________________________________________________________________________________ CCE/AFT Local #4522 Union Member Name

I, ___________________________________________________, verify that I have been a member in good standing in the CCE/AFT Local #4522, I have been a member since ________________________

___________________________________________________________________________________ Signature of Union Member Date

I verify that the above information is true and complete to the best of my knowledge.

___________________________________________________________________________________ Signature of Applicant Date

FOR UNION USE ONLY

Member Name:

_________________________________________________________________________________

Membership Dates:

__________________________________________________________________________________

In good standing: Yes No

Membership verified by:

___________________________________________________ Date:__________________________