Name: Home Address: Home Phone: Email: Name of High School: School Address: name and contact information


Gender: Cell Phone:

Ethnicity: __ Zip:____ __



__ Zip:____


How did you find out about this scholarship? (If a person referred you, please state their

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


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: Phone Number / Email: Relationship:

2. Name: 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