BROTHERS' FORUM OF THE UNIVERSITY OF LA VERNE

Scholarship Application for Academic Year 2022-2023

Submit the completed application to the Center for Multicultural Services by Friday, September 9, 2022 at
5:00 p.m. For further information, contact Dr. Daniel Loera, dloera@laverne.edu or 909.448.4321.

THE BROTHERS' FORUM Scholarship is derived from the David and Lucile Packard Foundation and was
created to support the academic success of Brothers’ Forum members at the University of La Verne. THE
BROTHERS' FORUM is an organization dedicated to support and assist African American males and broadly
support men of color on campus throughout their social and academic endeavors.

SCHOLARSHIP USE: The Brothers' Forum scholarship will be applied to the student’s account and will
cover institutional charges such as tuition, specific fees, and room & board. Students are eligible
to receive this scholarship up to five years, but each year must submit an application and be in
good standing. There is no guarantee that a student will receive this scholarship consecutively
from year to year. Scholarship committee will review all applicants.

ELIGIBILITY REQUIREMENTS: In order to be eligible for the Brothers' Forum Scholarship the following
criteria must be maintained throughout the 2022-2023 academic year.
 Must be enrolled as a full-time student for Fall and Spring (one semester, if graduating)
 Cumulative grade point average 2.4 preferred (But All encouraged to apply)
 Must attend and be actively involved in Brothers' Forum events and meetings
 Must meet regularly with assigned mentor
 Must have financial need
Failure to meet the above criteria at any point of the academic year will jeopardize this scholarship.

APPLICANT INFORMATION

Last Name First Name Middle Name

Mailing Address City State Zip

Permanent Address City State Zip

Cell Phone Other Phone Expected graduation date

Email Student ID # Academic Advisor

Declared Major Class Standing (Fresh, Soph, etc…) Number of units completed

Previous Brothers' Forum Scholarship Recipient: _____Yes _____No Current GPA: _______

ESSAY QUESTION: Please respond to the following question in no less than 3 paragraphs:
Who are you, why is education important to you, and how will education support your career goals?

Submit completed application to:

dloera@laverne.edu or Center for Multicultural Services, Ludwick Center, room 204