Name: Gender: Ethnicity:

Home Address: City:_______ __ Zip:____ __

Home Phone: Cell Phone:
Email:
Name of High School:
School Address: City:_______ __ Zip:____ __
How did you find out about this scholarship? (If a person referred you, please state their
name and contact information)

List all colleges you have applied to below (use additional sheets, if needed):

List all extra-curricular activities, including work (use additional sheets, if needed):

By signing below, I hereby proclaim that all information in this entire application is
factual and true to the best of knowledge.

Applicant signature Date

Letters of Recommendation
Please list two people who will provide letters of recommendation (teachers, staff,
and/or other adult recommenders). Letter of recommendations may be included along
with other application materials. If recommenders choose to mail letter themselves,
they must include the applicant’s full name and current high school and must ensure to
postmark letter by April 10th, 2009.
1. Name: Relationship:

Phone Number / Email:

2. Name: Relationship:

Phone Number / Email:

Statement of Financial Need (one-page limit)

Please provide a statement for your particular financial situation and the need for
financial assistance to attend college. You can include information about other
scholarships you are seeking, family’s financial situation, etc.

Written Response
Please provide a brief response to one of the following questions. Write the question
you choose at the top of your paper. Your response must not exceed 1000 words:

• Provide an autobiography including your dreams, hopes, and aspirations.

• How would you describe your overall high school experience and what do you
expect to gain by enrolling in college?

• What has served as your greatest motivation for attending college next year?

• Cesar Chavez once said, “Students must have initiative; they should not be mere
imitators. They must learn to think and act for themselves - and be free.” Give us an
example of a time that you have shown initiative?

Chicano Organizing and Research in Education Que Llueva Café Scholarship

Official Transcript
Please include your most recent high school transcript with your application. Your
application will not be considered until a transcript is provided.

Please review each submitted page to ensure that the applicant’s name is clearly
included. This is necessary so that all materials are part of the review process.

Sending Application Materials:

Please place ALL application materials into one large envelope and postmark by
Friday, April 10, 2009 and mail to:

Chicano Organizing and Research in Education (CORE)

Attn: Que Llueva Café Scholarship
P. O. Box 160144
Sacramento, CA 95816

All applicants will receive notification by June 2009.

Chicano Organizing and Research in Education Que Llueva Café Scholarship