Re-Entry Scholarship Application Name First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Email:Phone:Amador County Residence: Dates (at least 2 of the last 6 years):Address (if different from above):Date of Birth:Partner’s Name:Children: Selection of the scholarship recipient will be made based on the following priorities: (1) Need, please be specific (items 1-5, below); and (2) Consideration of personal and professional goals and objectives (item 6, below). 1. Current sources and amounts of income. Failure to include specific amounts will result in denial of application.A. Employment: Are you currently employed? Yes No Position held:Income: $B. Paid Community Activities–Please list:C. Expected income for your education from family: estimated amount for year:D. Other sources of income.2. Expenses (monthly or annually)Rent, including utilities: $B. Transportation: $C. Food: $D. Incidentals, additional expenses such as clothing: $E. Number of children/dependents:Ages:F. Tuition/college costs:$G. Books: $H. Other expenses:3. Have you ever attended college? If so, name of college and location:NOTE: While previous college attendance is not required, you must have a plan to resume your education. The scholarship will be awarded only upon PROOF OF REGISTRATION for fall/spring semester.A. Major or Subject area:B. Units: Number you plan to carry:4. List any special awards, achievements, honors (Include dates earned) from any organization to which you might have belonged:5. In what community activities (volunteered or paid) have you engaged?6. Submit an essay including the following: A. A brief autobiographical sketch. B. Your personal and professional goals for the future. C. What has influenced your goals? D. Why do you feel it is important for you to be educated at this time?Upload EssayMax. file size: 3 MB.APPLICATIONS MUST BE RECEIVED BY MARCH 15. Applications will not be returned. Δ
