Café Reconcile /Delgado Foundation Scholarship
*NOTE: Student must submit FAFSA to Delgado to be considered for this scholarship
Name: First, Middle, Last / Social Security NumberStreet Address / Date of birth:
City, State, Zip / Emergency Contact Name
Home Phone: / Emergency Contact Relationship
Cell Phone: / Emergency Contact Phone Number
Can we contact you via text message?
Yes
No / Gender:
Male
Female / Today’s Date:
______
Employment Status: / Café Reconcile Information:
Are you currently employed?
Yes
No / Did you graduate from Café Reconcile?
Yes
No
If yes, are you:
Full time
Part Time / If yes, when?
Date: ______
If yes, do you have benefits?
Yes
No / Voluntary Demographic Data:
Would you be the first person to go to college in your family?
Yes
No
Ethnicity:
Hispanic or Latino
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Employer’s name:
Job Title:
Average Hours worked per week:
Hourly Wage:
Café Reconcile /Delgado Foundation Scholarship
*NOTE: Student must submit FAFSA to Delgado to be considered for this scholarship
Legal / Scholarship InformationHave you ever been convicted of a crime? (Note this will NOT exclude you from the scholarship.)
Yes
No / How did you hear about the scholarship?
Delgado
Café Reconcile
If yes:
Felony
Misdemeanor
Gross Misdemeanor / Have you applied for this scholarship before?
Yes
No
Education Information
Are you currently a Full-Time student at Delgado?
Yes
No
Please write your program of study below:
Please write your LoLA number in the space below:
Award Amount: $1,000 for 15-16 school year.
Deadline: June 30, 2015
Delgado Foundation/Café Reconcile Scholarship
Short Answer Questions
*NOTE: Student must submit FAFSA to Delgado to be considered for this scholarship
1.) What was your time at Café Reconcile like? What advice would you give new applicants to the program?
2.) What do you see for yourself in the next five years? How would this scholarship help you accomplish your goals? Please be specific.