Part I. Personal Information:

First name

Last name

Street address

City

Zip

Home phone

Mobile phone

Email

Date of Birth

Are you a U.S. Citizen or U.S. Permanent Resident?

Yes

No

Notsure

Part II. Education Information:

Name of current school

GPA (unweighted)

Weighted GPA

Graduation date

SAT and/or ACT Scores

Please provide SAT and/or ACT scores if you have taken the tests. These scores are NOT required.

SAT Math

SAT Reading

ACT Math

ACT Science

ACT English

ACT Reading

Please list Academic Awards, Honors, Employment Promotions, and Community Recognitions:

Have you been accepted at Valencia College for the 2023 fall semester?

Yes

No

Degree you are planning to pursue and what you would like to do with that degree once you obtain your AA or AS Degree.

Part III. Leadership/Service/Work/Extracurricular Activities

Activity

Roles and Responsibilities

Activity

Roles and Responsibilities

Employer

Job and Responsibilities

A resume or additional sheet may be added as a supplement to the application if there are more activities to report.

Part IV. Essay Questions:

Please answer all three questions below as they are given extra consideration in the selection process. Each essay response should be a minimum 250 words and is not to exceed 500 words. Please upload a Word or PDF formatted file for each question.

What personal challenges have you had to overcome to achieve your goals of completing your high school education? How will you use these experiences to help you achieve your next goal of graduating from college?

How will this scholarship help you financially achieve your dream of going to college?

Once you graduate from college, what do you see as the next phase of your life? Please give us some insight into your dreams about the future after graduation and why a degree is important to you.

Part V. Final Matters

Please upload up to three (3) letters of recommendation in Word or PDF format.

Please upload your transcripts in PDF format.

Please upload your acceptance letter in PDF format.

If our club offered a mentorship or internship program, would you be interested?

Yes

No

By clicking "Accept" below, you agree that all of the information provided herein is true and correct and that you agree to the terms of this scholarship offer if selected.

Accept

If Applicant is under 18 years of age, a parent or guardian must complete the following:

Name

I am the Applicant's

Parent

Guardian