(2013-2014) WEST VALLEY/MISSION COLLEGE

SCHOLARSHIP APPLICATION

 

(For Current West Valley/Mission College Students)

Please Print (BLACK INK) or Type-This document will be photocopied

 

GENERAL INFORMATION

 

 

Name:____________________________________________ SS#____________________

     Last             First       Middle

 

Address: _______________________________________  Date of Birth: ________

 

City/Zip: ________________________ Phone #: ___________________

 

Email address: __________________________________________________

 

Name of Tribe, Band, or Group _________________________________

__ Federally recognized

(include Alaska Native)

                                          __ State recognized

                                          __ Terminated

Marital Status:                           __ Other Organized Group

___ Single  ___ Married       Membership in name of _____________________

___ Head of Household __Other

___ Household size

 

EDUCATIONAL BACKGROUND

 

Name of high school attended: _______________________

 

Graduated: __ Yes       Graduation date: ______________     G.P.A. _____

           __ No        GED?  __Yes  __ No

 

List the course title and units of current enrollment at the college

            Course Title                        Units

______________________________________          ______

 

______________________________________          ______

 

______________________________________          ______

 

______________________________________          ______

 

Total number of units completed at West Valley/Mission College(circle):

______ units            ______G.P.A.

Other colleges:_________________________________________________

______ units            ______G.P.A.

      Note: GPA must be a minimum of 2.5

 

__________________________________________________________________

 

College Major: _____________________

      Degree: __Certificate   __

 

DEADLINE: Friday, Sept. 27