Name of Applicant:

2014MARIPOSA/MADERA COUNTY ACSA CHARTER

Scholarship Application

PART I: ELIGIBILITY

The scholarship review committee has established the following criteria for eligibility.

YOU MUST:

1)have one or a combination of the following qualifying criteria:

-have a parent/guardian who is a member of ACSA

-be a member of an educational club, organization or activity

-plan on being a teacher

-have a parent/guardian who is a school administrator or teacher

2)be a full-time student in one of the following:

-Chawanakee Unified School District

-Chowchilla High School District

-Golden Valley Unified School District

-Madera County Office of Education

-Mariposa County Unified School District

-Yosemite Unified School District

3) be a graduating senior

PART 2: APPLICATION PACKET

The application packet MUST include the following:

1)A completed scholarship application

2)Two (2) letters of recommendation. One letter MUST come from someone in education. Letters from relatives will NOT be accepted. All letters must be dated and signed.

3)An official transcript signed by your school’s registrar.

INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED.

ALL APPLICATIONS SHOULD BE RETURNED TO:

Dianna Marsh

Mariposa/Madera County ACSA

1105 South Madera Avenue

Madera, CA 93637

DEADLINE: APRIL 4, 2014

Name of Applicant:

Name of Applicant:

2014MARIPOSA/MADERA COUNTY ACSA CHARTER

Scholarship Application

$500

PLEASE TYPE OR PRINT YOUR APPLICATION

1) Eligibility-please fill out the following:

My parent/guardian is a member of ACSA.

List the charter

I am a member of an educational club, organization or activity

List the club, organization or activity I plan on being a teacher

My parent/guardian is a school administrator or teacher

District

2) School Attendance

I am a graduating senior at High School in the School District.

This page must be filled out and returned with your

application.

DEADLINE: APRIL 4, 2014

Name of Applicant:

#

Name of Applicant:

Name of Applicant:

2014MARIPOSA/MADERA COUNTY ACSA CHARTER

Scholarship Application

$500

DEADLINE: APRIL 4, 2014

Name:

Home Address:

City: ZIP:

Home phone: Date of Birth:

Parent/Guardian Name(s):

Parent/Guardian Occupation(s):

Brothers and sisters who live at home:

First NameAge

Family members living in your home in some form of higher education:

NameSchool

List other people that your parents or guardians support. For the purpose of this scholarship the definition of support is a minimum of $100 per month.

Name of Applicant:

2014MARIPOSA/MADERA COUNTY ACSA CHARTER

Scholarship Application

$500

What school or college do you plan to attend commencing this year?

First choice:

Second choice:

Use additional paper if needed: (applicant may use resume if it answers all of the

following questions)

1.Describe briefly your plans for college and future vocations, both short and long range.

2.Please list all extra curricular activities that you have been involved in during your high school years. Please include school and non-school activities.

3.List all community activities you are involved in, the number of years and any offices held.

4. Please list all honors and awards you have received.

5. What work experience have you had?

6. Please list any additional information that may be helpful to the scholarship committee.

(Please attach any additional papers)

DEADLINE: APRIL 4, 2014