United Belizeans of Northern Illinois 2013 Scholarship Application

Application Deadline is June 1st, 2013. Application must be complete with all 6 requirements. Incomplete application will not be accepted and no applications will be accepted after that date.

____________________________
Applicants Name

_____________________________
Applicants Address

Application Checklist:
Scholarship Application: All sections of this application must be completed. The students must sign and
date the last page of this application. Application Deadline is June 1st, 2013. No applications will be accepted after that date.

Essay: Must be 500 words typed, double space, Times New Roman. Please choose one topic
1.What experiences have prepared you to excel academically? 2.What are the most important forces that motivate you as a student ? 3. Why is cultural identity important to you?

Transcripts: Submit an official High School/Transcript indicating your most recent academic work. Letter Of Recommendation: The student must submit (1) letter of recommendation Release of Consent Form Acceptance Letter from College or University

Who is Eligible? Students are eligible to be considered for $500.00 UBNI Scholarship if
they: * Are of Belizean Descent * Are residents of Lake County Illinois * Enrolled at least 6 credit hours at a local community college or University * Have attained a cumulative High School GPA of 2.75 or higher * Have demonstrated leadership abilities through participation in community service, extracurricular, or other activities. * Have completed and submitted all required forms * All finalists must be present for an interview with members of the UBNI Scholarship committee board. * Attend UBNI Gala in August to receive Award * Application Deadline is June 1st, 2013. * Scholarship is non-renewable Please submit all materials to: United Belizeans of Northern Illinois Attn. Scholarship Committee P.O. Box 1036 Waukegan, Illinois 60079
Questions?? Contact (224)280-5093 or (847)226-0976 or via email at selenicocom@att.net or rvidal1027@yahoo.com

United Belizeans of Northern Illinois 2013 Scholarship Application

Application Deadline is June 1st, 2013. Application must be complete with all 6 requirements. Incomplete application will not be accepted and no applications will be accepted after that date.

Personal Information:
First Name Address Middle Name or Initial Last Name

_____________________________________________________________ __________________________ ________

City State Zip

_______________________
Telephone

______________________________________________________________________________________ Email Address (if available) Date of Birth:________/________/________ Gender: Male______ Female______

Parent(s) or Guardian with whom you live:

Name__________________________________Relationship_____________________________________ Name__________________________________Relationship_____________________________________

Academic Background
Name of Your Current High School_________________________________________________________

________________________________________________________________________
City Expected Graduation Date:_________ State Zip Class Rank:_______________ out of_________________

Grade Point Average:_______________

ACT Score (Composite)___________________

College/ University or Trade School you plan to attend in fall of 2013:_____________________________ ______________________________________________________________________________________ City State Zip Circle one: 2-year Institution 4-year Institution

__________________________________________________________________________________ Major Career Goals

________________________________ Signature of Applicant

_______________ Date

Questions?? Contact (224)280-5093 or (847)226-0976 or via email at selenicocom@att.net or rvidal1027@yahoo.com

United Belizeans of Northern Illinois 2013 Scholarship Application

Application Deadline is June 1st, 2013. Application must be complete with all 6 requirements. Incomplete application will not be accepted and no applications will be accepted after that date.

Consent of Release Form Photo/Video Release

I, ______________________________________give my consent to_____________________________________ to ( name of parent/guardian if applicant is minor ) ( name of applicant) be videotaped, photograph, audio taped, and/or interviewed for United Belizeans of Northern Illinois, for the purposes of publicity, advertising, or media coverage related to the activities of the United Belizeans of Northern Illinois scholarship program. I understand that social medias will be utilized to promote the mission of UBNI.

Parent/ Guardian Signature ______________________________________Date ___________________

Questions?? Contact (224)280-5093 or (847)226-0976 or via email at selenicocom@att.net or rvidal1027@yahoo.com