LOS MEDANOS COLLEGE FOUNDATIONSCHOLARSHIP APPLICATION

Through one convenient application, LMC students can apply for a variety of scholarships. Learn how below.

TO BE CONSIDERED FOR AN LMC FOUNDATION SCHOLARSHIP YOU MUST:

Be a Los Medanos College student Have a minimum gpa of 2.0 (a higher GPA may be required depending on the scholarship) Submit supporting documents (i.e., essay, two letters of recommendation, and a copy of your

unofficial transcript) Meet all the eligibility requirements of scholarship(s) for which you are applying

REQUIRED SUPPORTING DOCUMENTS FOR ALL LMC FOUNDATION SCHOLARSHIPS:1. A completed, typed and signed 2015-2016 LMC Foundation Scholarship Application2. Two letters of recommendation – One letter must be from an LMC staff member3. A typed 250-500 word essay/personal statement addressing your financial situation, educational

and career goals, community service, school activities, work experience, etc. NOTE: One essay will suffice for all scholarships. HOWEVER, you must answer any and all specific questions asked per individual scholarship and include in the essay

4. An unofficial LMC transcript (may be obtained from WebAdvisor/Insite at www.losmedanos.edu

INSTRUCTIONS:CHECK THE BOX(ES) FOR THE SCHOLARSHIP(S) YOU FOR WHICH WISH TO BE CONSIDERED AND CONTINUE FILLING IN THE REST OF THE APPLCATION. YOUR APPLICATION MUST BE TYPED.

VERY IMPORTANT: AFTER YOU ARE DONE FILLING IN YOUR APPLICATION, PRINT AND SIGN YOUR COMPLETED APPLICATION AND RETURN IT TO THE SCHOLARSHIP COORDINATOR , STUDENT SERVICES CENTER (SS3, ROOM 309), WITH SUPPORTING DOCUMENTS (ESSAY, LETTERS OF RECOMMENDATION AND TRANSCRIPT) BY THE DEADLINE DATE BELOW.

DECISIONS WILL BE EMAILED TO STUDENTS’ INSITE PORTAL IN APRIL 2015.

DEADLINE: FEBRUARY 12, 2015 BY 5:00PM

2015 LOS MEDANOS COLLEGE FOUNDATION SCHOLARSHIP APPLICAITON

Student Name:_ _____ Student ID: _ __

This page must be attached to your completed application packet

African-American Staff Scholarship-Cont Student Janhavi Stewart/Malik Stewart LVN Scholarshp

African-American Staff Scholarship-Tran Student Jeffrey Lieske Math Scholarship

American Assoc of University Women-Concord Branch Jennifer Victor Memorial Scholarship

American Assoc of University Women-CC Delta Branch Josie Gardunio Memorial Scholarship

Antioch Rotary Club Scholarship La Raza Faculty and Staff Scholarship-Cont Student

Brentwood Center Scholarship La Raza Faculty and Staff Scholarship-Tran Student

Brentwood Rotary Club Scholarship Leung family Memorial Scholarship

Bob Zavala "Making a Difference in the Lives of Children" Scholarship

LMC Carol & John Slatten Nursing Scholarship

LMC Former Foster Youth Scholarship Brian Benzler Memorial Scholarship LMCAS (Assoc Students) Scholarship

Carla Zilbersmith Memorial Scholarship LMCAS (Assoc Students) Breast Cancer Scholarship

CCCSAA (California Community College Student Affairs Association) Student Leadership Scholarship

LMCAS (Assoc Students) HOSTS Scholarship

Matthew Shepard Tolerance Scholarship

Classified Senate Student Scholarship-Cont Student Ofelia Marino Memorial Scholarship

Classified Senate Student Scholarship-Tran Student Osher Scholarship

Danielle Lieske Science Scholarship Perry-Folino Dramatic Writing Scholarship

Dean Lesher Scholarship Pittsburg Latin-American Club Scholarship

Doyle Hawkins Memorial Scholarship-Cont Student Pittsburg Rotary Club Scholarship

Doyle Hawkins Memorial Scholarship-Tran Student Powers Family Scholarship

Ellen Swallow Richards Scholarship Richard Livingston Scholarship

Enes Bramhall Memorial Scholarship S.L. Meigs memorial Scholarship

Gene Thomas Memorial Scholarship Socorro Miranda Memorial Scholarship

George J. and Dera M. Lewis Scholarship Soroptimist Intl’ of Antioch Scholarship

Gloria Garlitos Memorial Scholarship Soroptimist Intl’ of Pittsburg Scholarship

Harriett Shaffer Anti-Bias Scholarship Stanley H. Chin Memorial Scholarship

Industrial Association of CCC Scholarship Vince and Mary Custodio Scholarship

Inter-Club Council Scholarship Walking Miles Against Violence Scholarship

2015 LOS MEDANOS COLLEGE FOUNDATION SCHOLARSHIP APPLICAITON

CONTACT INFORMATION

Student Name:__ _ Student ID:__ ___

Permanent Home Address:_ ____

Phone #:__ ___

Email Address:__ __

Gender: Male Female

U.S. Citizen: Yes No

I am an: International student Out-of-state student In-state student AB540

Marital Status: Single (never married) Married Divorced Separated

Are you currently registered in the LMC’s Disabled Students Program? Yes No

LMC Class Standing: Freshman Sophomore What is your GPA? _ _

LMC college major? _ _ Career Choice:_ __

Degree Pursuing (at LMC): Associate Certificate of Achievement None

How many LMC units currently enrolled in? __ _ How many LMC units completed?_ _

Expected Graduation Date: __ _

Will you be continuing at LMC Fall 2015 and Spring 2016? Yes No

Will you be transferring from LMC to a 4-year college/university in the Fall 2015 semester? Yes No, or Spring 2016 semester? Yes No If ‘yes', list campus of transfer _ ___

SUPPLEMENTAL INFORMATION

1. Do you reside with your parents? Yes No Spouse? Yes No

2. How many persons will be living in your household during 2015-2016? _ ____

3. Of the number of persons in questions #2, how many will be in college full-time during the 2015-2016 academic year? __ _____

4. During the 2015-2016 academic year, will you be a single parent with dependent children living with you? Yes No If ‘yes’, how many? _ _

5. How many hours per week do you work? _ _

6. What was your adjusted gross income for the 2014 year? (If unknown at this time, use 2013 information) _ _

7. What was your parent’s or spouse’s adjusted gross income for 2014? (If unknown at this time, use 2013 information) _ __

2015 LOS MEDANOS COLLEGE FOUNDATION SCHOLARSHIP APPLICAITON

8. Have you applied for Financial Aid (submitted a FAFSA form)? Yes No

9. Have you applied for the Dream Act? Yes No

10. Any extenuating financial needs or reason for lack of community services you would like to be considered? _ _

I certify that I have read all the information and instructions regarding this application. I also agree to all stipulations written herein. I certify that the information provided in this application is, to the best of my knowledge, true and correct. I understand that all information is subject to verification and that falsification of information may result in termination of any scholarship granted. I give permission for the release of application materials (including application forms, transcripts, personal statement, and letters of recommendation) to authorized Los Medanos College scholarship committees and/or Los Medanos College Foundation donors.

IMPORTANT: Scholarship awards are intended for use during the academic year for which they were awarded. If you were awarded an LMC Scholarship and you do not use that award during the current academic year (Fall 2015 and Spring 2016 semesters) your award(s) is/are subject to forfeit. Visit, call, or, contact the Scholarship Office with any questions.

Student Signature Date

Guardian Signature (only if student is a minor under the age of 18) Date

2015 LOS MEDANOS COLLEGE FOUNDATION SCHOLARSHIP APPLICAITON