CHASING YOUR DREAMS 2017 SCHOLARSHIP

Application
Scholarship given by:

McDonalds/Hernando and Fran Marroquin Family

APPLICANT Last Name_________________________ First________________________ Middle Initial ___________

DATA Mailing Address _____________________________________________________ Apt. #_____________
City___________________________________________ State __________Zip Code_________________
Telephone (_______) ________________________ Cell Phone (______) __________________________
Date of Birth ______________________________ Place of Birth ________________________________
Gender ______________Email Address ____________________________________________________
Last 4 Digits of Social Security Number __________ Date of Birth: Month _______Day ______ Year ____

PARENT Last Name_________________________ First________________________ Middle Initial ___________

OR Mailing Address _____________________________________________________ Apt. #_____________
GUARDIAN City_______________________________________ State __________Zip Code_________________
INFORMATION Relationship to Applicant ____________________________________Telephone (______) ________________
__________________________________________________________________________________________________________

HIGH School Name _______________________________ Graduation Date: Month _________ Year __________
SCHOOL City ___________________________________ State ____________ Telephone (______) _______________
DATA Cumulative Grade Point Average ___________________
__________________________________________________________________________________________________________

POST Name of postsecondary school you plan to attend. (If unknown, please list in order of preference the schools to
SECONDARY which you have applied. Use official school names. Do not use abbreviations.
SCHOOL
DATA _________________________ _____________ City___ _____________________________ State ____________
_________________________ _____________ City___ _____________________________ State ____________
4 yr. College or University 2yr. Community or Junior College

Other, explain __________________________________

Major or course of study: __________________________ Career Objective _________________________________________

__________________________________________________________________________________________________________
WORK Describe your work experience during the past four years. Indicate dates of employment for each job.
EXPERIENCE

Employer/Position From Mo/Yr. To Mo/Yr.

ACTIVITIES, List all school and community activities in which you have participated during the past four years. (e.g.; student
AWARDS AND government, music, sports, Boy/Girl Scouts, hospital volunteer, Special Olympics. Note all special awards, honors
HONORS and offices held.

Activity Yrs. Awards Offices Held Activity Yrs. Awards Office Held
Partic. Partic.

__________________________________________________________________________________________________________

PERSONAL Please attach a 500 word or less essay stating the challenges of your life and what you have done to
STATEMENT to overcome them.

LETTERS Please attach two (2) letters of recommendations.

OF
RECOMMENDATIONS

Applications are due by March 1st 2017. The student is responsible for submitting all materials.
Incomplete applications will not be evaluated.
Completed applications can be returned to:
Local High School Counseling Office

Recipient will be notified of award ceremony date. Scholarship money will be given through the High School District office
with proof of enrollment in a 2 or 4-year college or university.

__________________________________________________________________________________________________________
CERTIFICATION
Applicants Signature _________________________________________ Date_____________________________

Parent/Guardians Signature____________________________________Date_____________________________