Due by May 16, 2016 at 5:00 p.m., No Exceptions

Name: ______Birth Date ___/___/___

First Middle Last

Address: ______

Address Street City Apt/Suite# Zip

Phone: (_____)______E-Mail: ______

Fullerton College ID Number: ______

Anticipated completion of certification or graduation date: ______Cumulative GPA: ______

Units Completed to Date: ______

Your application packet will include:

·  A description of your current field of interest or career choice.

·  Completion of all questions listed on the Joan & Burnie Cohen Scholarship Form. (Use additional pages, if necessary).

§  Unofficial transcripts for Fullerton College, including Fall 2015 and Spring 2016 Semesters.

NOTE: Print transcripts showing class completions and grades—Must be provided to receive scholarship monies.

§  Two current letters of recommendation from either your educational advisor, professor, or your employer.

Return completed application information to:

·  YWCA of North Orange County, ATTN: Joan & Burnie Cohen Scholarship Fund, 215 E. Commonwealth Avenue, Suite E, Fullerton, CA 92832. E-mail to

Or

·  Fullerton College Foundation, P.O. Box 431, Fullerton, CA 92836. E-mail to

Joan & Burnie Cohen Scholarship Fund-Application Form

All questions must be answered to be considered for this scholarship. Please tell us about yourself by responding to the following questions. (Use additional pages, if necessary)

1.  What are your educational and career goals?

2.  What is your biggest challenge in attending college?

3.  In what way(s) do your family, friends, or work, support your decision to attend college?

4.  How do you manage your home responsibilities, job, schoolwork, and other family activities?

5.  What do you consider your personal strengths?

Joan & Burnie Scholarship Fund- Application Form

6.  Describe your campus and/or community involvement.

7.  If you receive the Joan & Burnie Cohen Scholarship, please explain in detail how this award money will help you to fund your education. Please include any other information that impacts your financial situation.

8.  Please include any other information that is important to know about your application for this scholarship.

9.  Have you received financial aid, scholarships, awards or loans in the past two (2) years?

(Check one) ____YES ___ NO

10.  If yes, please list all types of Financial Aid, Scholarships, Awards or Loans received for each one.

a.  Name

b.  Amount Received

c.  Date Awarded

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