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2017 Senior Care Scholarship DESCRIPTION A Place for Mom is proud to offer our annual $1,000 scholarship to university students interested in the fields of aging and gerontology. As the North America's largest senior living referral service, we know the importance of supporting the training and education of our future senior care leaders. This scholarship will be awarded to a citizen or a Permanent Resident of the United States or Canada (excluding Quebec) who is enrolled and currently taking classes at an accredited college or university in the United States or Canada (excluding Quebec), and will grant selected applicants a $1,000 financial donation for their compelling essays on life lessons learned from a senior. SELECTION AND ELIGIBILITY CRITERIA 1. The annual scholarship award is for (5) students enrolled in an associate's degree, bachelor's degree or graduate level program in a medical, nursing or social sciences related major. The student must be planning on pursuing a career that involves working with senior citizens.The applicant must be attending classes at an accredited college or university at the time of the spring deadline. 2. Employees of A Place for Mom and members of their immediate family (spouse, parent, child, sibling and their respective spouses, regardless of where they reside) and persons living in the same household, whether or not related, of such employees, are not eligible to apply. 3. Applicants must complete the student information form, a 400 to 700 word essay on the selected topic and sign the Scholarship Award Agreement 4. Scholarship will be awarded to five students who write the most compelling essay as judged by an outside panel of senior living professionals. AWARD AMOUNT $1,000 awarded to five individuals. INSTRUCTIONS FOR APPLICANTS 1. Please fill out the short online student information form. 2. Send a signed copy of the Scholarship Award Agreement to [email protected], the easiest way to do this is to print the PDF file, fill it out and scan it back into your computer so that you can email it as an attachment. Alternately, you can print it, fill it out and then take a clear picture of it and email that file to us. 3. Send your essay to [email protected], essays should be between 400 and 700 words long. 4. Essays and signed agreements may be sent in the same email, please make sure your name is in the subject line. 5. You must be planning on a career working with senior citizens in order to be eligible for this scholarship. 6. All application materials must reach us by 11:59pm April 15, 2017.
Transcript
Page 1: 2017 Senior Care Scholarship - az480170.vo.msecnd.netaz480170.vo.msecnd.net/29058da5-9375-4249-a41b-9e... · 2017 Senior Care Scholarship DESCRIPTION A Place for Mom is proud to offer

2017 Senior Care Scholarship DESCRIPTION

A Place for Mom is proud to offer our annual $1,000 scholarship to university students interested in the fields of aging and gerontology. As the North America's largest senior living referral service, we know the importance of supporting the training and education of our future senior care leaders.

This scholarship will be awarded to a citizen or a Permanent Resident of the United States or Canada (excluding Quebec) who is enrolled and currently taking classes at an accredited college or university in the United States or Canada (excluding Quebec), and will grant selected applicants a $1,000 financial donation for their compelling essays on life lessons learned from a senior.

SELECTION AND ELIGIBILITY CRITERIA

1. The annual scholarship award is for (5) students enrolled in an associate's degree, bachelor's degree or graduate level program in a medical, nursing or social sciences related major. The student must be planning on pursuing a career that involves working with senior citizens.The applicant must be attending classes at an accredited college or university at the time of the spring deadline.

2. Employees of A Place for Mom and members of their immediate family (spouse, parent, child, sibling and their respective spouses, regardless of where they reside) and persons living in the same household, whether or not related, of such employees, are not eligible to apply.

3. Applicants must complete the student information form, a 400 to 700 word essay on the selected topic and sign the Scholarship Award Agreement

4. Scholarship will be awarded to five students who write the most compelling essay as judged by an outside panel of senior living professionals.

AWARD AMOUNT

$1,000 awarded to five individuals.

INSTRUCTIONS FOR APPLICANTS

1. Please fill out the short online student information form. 2. Send a signed copy of the Scholarship Award Agreement to

[email protected], the easiest way to do this is to print the PDF file, fill it out and scan it back into your computer so that you can email it as an attachment. Alternately, you can print it, fill it out and then take a clear picture of it and email that file to us.

3. Send your essay to [email protected], essays should be between 400 and 700 words long.

4. Essays and signed agreements may be sent in the same email, please make sure your name is in the subject line.

5. You must be planning on a career working with senior citizens in order to be eligible for this scholarship.

6. All application materials must reach us by 11:59pm April 15, 2017.

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ESSAY TOPIC

Author Andy Rooney once said "The best classroom in the world is at the feet of an elderly person." What is the one most important life lesson that you have learned from a grandparent or other senior in your life? Who was or is the senior in your life who inspires you? How will you use the lesson learned from them in your future career working with seniors?

A Place for Mom may choose to not award or to withdraw the Scholarship Award for any reason. Award recipients will be notified individually and announced by June 1, 2017.

Congratulations and thank you to all of the dedicated students who applied in 2016, the five 2016 winners were announced on May 31, 2016. You can read the ten 2016 finalist essays here.  

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Hello!

I hope this email finds you doing well! As the weather is beginning to break, the trees are starting to bloom and of course new students are soon ready to begin their college careers - I'm excited to announce cuLearn with Thrivent’s Spring and Summer Scholarship Program!!!!

Lucky winners will each receive a $5,000 scholarship to put toward their college costs. New this year, instead of having only one drawing, we will conduct drawings throughout the Spring, Summer and Early Fall. (April 1, June 12, August 7 and October 6).

Scholarship Application/Details

· Go to: http://info.culearn.com/connect

· No essay is required!

· Only one entry per person.

· Students do not need to be a member, borrow a loan, etc. to qualify!

Feel Free to share with your scholarship and admissions teams!

WHO is Thrivent Financial?

Thrivent Financial is a NON- PROFIT Fortune 500 private company with over 2.4 million members that has traditionally helped individuals with retirement planning, annuities, college planning, college loans, life insurance, etc. Additionally, Thrivent’s philanthropic programs and service to others is unmatched in the financial world - backed up by over 10.7 million volunteer hours and over $250 Million in charitable donations to 501c3 organizations and other causes. Additional philanthropic programs that are taking part by students across the country are Thrivent Action Teams! (more info: https://www.thrivent.com/making-a-difference/living-generously/thrivent-action-teams/)

Take care and have a wonderful upcoming weekend!

Greg

Greg Carlo, MBA AVP, College Market Development cuLearn with Thrivent® 625 Fourth Ave. S., Minneapolis, MN 55415-1665 Cell: 614.769.4369 Email: [email protected]  

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Sigma Gamma Rho Sorority, Inc. (ΣΓΡ) was founded on November 12, 1922 at Butler University in Indianapolis, Indiana by seven educators. It is the mission of Sigma Gamma Rho Sorority to enhance the quality of life for women and their families in the U.S. and globally through community service. Our goal is to achieve greater progress in the areas of education, healthcare, and leadership development. Our members, affiliates, staff and community partners work to create and support initiatives that align with our vision. Sigma Gamma Rho Sorority, Inc. is the only one of the four National Pan-Hellenic Council (NPHC) sororities that was founded at a predominantly white campus. We understand the historic obstacles for youth to achieve higher education and continue to actively endeavor to eradicate remaining barriers. The Alpha Sigma Indianapolis Alumnae Chapter of Sigma Gamma Rho Sorority, Inc. is committed to helping young people succeed. This includes ensuring that students have access to the financial resources they need to obtain a college education. Eligibility for High School Seniors: Scholarships are open to all high school seniors who have been accepted for admission and will be attending an accredited college or university by the Fall semester of 2017. Scholarships are available to students attending high school within a 30 miles radius of Indianapolis, Indiana. To be eligible to apply, students must have a grade point average of at least a 2.8 (based on a 4.0 scale) and enroll in a full-time program at an accredited college or university during the 2017-2018 academic year. The funds will be dispersed directly to the college or university that the recipient enrolls in. Proof of enrollment must be provided before the funds will be dispersed. Academic achievement, community involvement, leadership positions, sports and other extracurricular activities will be considered. You do not have to be affiliated with Sigma Gamma Rho Sorority Inc. in any way to win a scholarship. All gender identities are welcome to apply. Eligibility for Current College Students: Scholarships are open to current college students who have at least one full year left of coursework to complete. Applicants must be currently attending an accredited college or university. Scholarships are available to students attending college within a 30 miles radius of Indianapolis, Indiana. To be eligible to apply, students must have a grade point average of at least a 2.8 (based on a 4.0 scale) and be enrolled in a full-time program at an accredited college or university during the 2017-2018 academic year. The funds will be dispersed directly to the college or university that the recipient enrolls in. Proof of enrollment must be provided before the funds will be dispersed. Academic achievement, community involvement, leadership positions, sports and other extracurricular activities will be considered. You do not have to be affiliated with Sigma Gamma Rho Sorority Inc. in any way to win a scholarship. All gender identities are welcome to apply. Scholarship Basics: Scholarship Amount: $2,000 non-renewable. One will be awarded to a high school senior and one to a current college student. Application Deadline: April 14, 2017 Completed application must be received by this date. Winner will be notified by May 15, 2017.

Sigma Gamma Rho Sorority, Inc. Alpha Sigma Indianapolis Alumnae Chapter

2017 Scholarship Application

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Applications must include the following items: • A completed application form with required signature(s) • An official, signed and/or embossed seal transcript • One letter of recommendation • A typed essay (not to exceed two pages) in response to topic question • A signature from a parent or guardian (if under 18 years old)

To download the application on-line, please visit: http://www.alphasigma1922.org Completed applications should be mailed to the address below. Incomplete applications will not be reviewed. All questions should be directed to [email protected] Sigma Gamma Rho Sorority, Inc., Alpha Sigma Alumnae Chapter C/O Scholarship Committee P.O. Box 88194 Indianapolis, Indiana 46208

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SIGMA GAMMA RHO SORORITY, INC. ALPHA SIGMA ALUMNAE CHAPTER 2017 SCHOLARSHIP APPLICATION

I. Applicant Information: Full Name _____________________________________________________________________________________ Home Address : ________________________________________________________________________________ ______________________________________________________________________________________________ Cell Phone Number (______) __________________________________ E-mail : __________________________________________________________ I am: ___________ High School Applicant ____________ College Applicant School Information: *Official Transcript Required High School or College Currently Attending: _________________________________________________________ Overall GPA: _________________based on _________scale (example 4.0) Current Careers of Interest: ________________________________________________________________________ II. Parent/Guardian Information (if under 18 years of age): Name:___________________________________________________________________________ Phone Number: ______________________________________________________________ E-Mail Address:_______________________________________________________________ III. Extracurricular Activities: (Please list activities and years involved. Only list your high school involvement for high school applicants and college involvement for collegiate applicants. Example: Book Club-1 year) IV. Volunteer Experience/Community Involvement: (Please list activities and years involved. Only list your high school

involvement for high school applicants and college involvement for collegiate applicants. Example: Nursing Home-2

years)

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V. Essay On an attached sheet, please describe how you have demonstrated leadership ability and a commitment to education during your high school or collegiate years and how you plan on continuing to do so as you continue your education. (Your essay response should be no longer than two pages double spaced, 12 point font.) VI. Applicant Signature I hereby certify that all the information provided in this application is accurate and current. I understand that this application packet and all materials submitted will become the final property of Sigma Gamma Rho Sorority, Inc., Alpha Sigma Alumnae Chapter. By signing in the space below, you are certifying that all information is correct and that you are the person completing this application. Signature of Applicant: __________________________________________________________________ Date: _____________________________________________________ Media Release and Photography Waiver I understand that in order to apply for this scholarship that my child may be photographed and their essay excerpts published upon winning. Applicant's Parent or Guardian (if under 18 years of age): ______ Parent _____ Guardian Name_____________________________________________________________________ Signature__________________________________________________________________ Date: ___________________________________________ Letters of recommendation cannot be from family members. Recommendation1: Name_______________________________________________________________ Title________________________________________________________________ Relation to Student____________________________________________________ Completed applications must be submitted by April 14, 2017. If you have questions, please contact us at [email protected]

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Two $500 Book Scholarships for the Spring semester of each school year

Criteria: Students must meet these requirements:

• Be a Martin University Junior or Senior student enrolled in the Spring semester

• Must have an accumulative G.P.A. of 2.5 or higher

• Must write a short essay of one to two pages (300 to 500 words) on a topic selected by the School 37 Alumni Committee:

A. Father Boniface Hardin

OR

B. A History of Martin University

• Provide a letter of recommendation from a Martin University instructor and one from a personal reference, e.g. Pastor, employer, etc.

Essays are due by April 15, 2017.

See the Martin University Requirements for Scholarship Submission on website @ www.martin.edu.

Submit completed essay to Doraine Reynolds-Malone at Martin University in the Office of Academic Affairs, located on the second floor of the Administration Building.

Awards will be made May 15, 2017 for the semester of Summer 2017.

The winners of the scholarships will be announced on the University website and in the Indianapolis Recorder newspaper.

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EDUCATION

Make education a priority, not an option

www.indianalatinoinstitute.org

Scholarship

This is an opportunity for students to earn a $1,000 scholarship towards their tuition. Applications are due

May 26, 2017. Eligibility requirements include:

Students must be planning to enroll in a minimum of 6 credit hours per semester in the 2017-2018

academic year

Students must be between the ages of 17 and 25 at the time of submitting application

Demonstrate academic achievement (minimum 2.7 GPA on 4.0 scale)

Demonstrate financial need (complete financial need form)

Document ongoing community service involvement

Preference given to Latino students residing in Indiana who are first generation college students

Summer Internship

This is an opportunity for students to have a 100-hour work experience in their field of study and earn a $500

stipend towards their tuition. Applications are due April 28, 2017. Eligibility requirements include:

Open to students who are graduating high school seniors through college seniors, who are between

age 18-25

Must enroll at a college/university in the state of Indiana at least part time for fall 2017 semester

Must participate in mandatory training on June 12, 2017—June 14, 2017

Preference is given to ILI program participants

Summer Fellowship

This is an opportunity for students who are in their senior year of college or graduate students to have a

300-hour work experience in their field of study and earn a $3,300 stipend paid directly to them. Applications

are due April 28, 2017. Eligibility requirements include:

Cumulative GPA of 3.0 or above

College senior or graduate student status in fall 2017

Must be between age 20-26

Must be a U.S. Citizen, Permanent Resident, or DACA (must be current at time of placement)

Must have reliable transportation, driver’s license and car insurance

Must enroll at a college/university in the state of Indiana at least part time for fall 2017 semester

Must participate in mandatory training on June 12, 2017—June 14, 2017

If you have any questions or would like additional information, please contact Grisel Barajas, ILI Education

Program & Communication Coordinator, at [email protected] or 317-472-1055.

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Indiana Latino Institute Fellowship Program www.indianalatinoinstitute.org

2017 Fellowship Application

Purpose The purpose of the ILI Fellowship Program is to provide gifted and highly motivated Latino students first-hand experience in their specific professional field—STEM, education, business, health, law, non-profit, government, etc. In addition to working for powerful organizations, fellows will have opportunities to build their professional skills, gain knowledge about the local community, and interact with local Latino leaders.

Fellowship Eligibility Requirements Cumulative GPA of 3.0 or above College senior or graduate student status in fall 2017 Must be between age 20-26 Must be a U.S. Citizen, Permanent Resident, or DACA (must be current at time of placement) Must have reliable transportation, driver’s license and car insurance Must enroll at a college/university in the state of Indiana at least part time for fall 2017

semester Must participate in mandatory training on June 12, 2017—June 14, 2017

Fellow Selection Process Fellowship applicants must submit the following documents by April 28, 2017:

Fellowship application and essay Two letters of recommendation Curriculum Vitae or Resume Background check Unofficial transcript

Applicants must display evidence of leadership skills and potential for further growth, a demonstrated commitment to their field of study, and initiative. These qualities, the strength of the application materials, and the strength of one’s character, a positive attitude, and the ability to work well with others are taken into consideration when selecting fellows for the ILI Fellowship Program. The fellowship site may request an interview prior to final placement.

Time Expectation Fellows are expected to complete 300 hours from June 2017 until August 2017. This includes working at the fellowship site from Monday through Thursday, and participating in the education program component on Fridays. These mandatory Friday meetings will run from 10 AM—3 PM.

Payment Information Fellows will be paid an hourly rate of $11 (300 hours x $11=$3,300). This hourly rate will be for hours completed at the fellowship site and on Fridays as part of the education program.

Submit Applications to Attn: Grisel Barajas Indiana Latino Institute 401 W. Michigan Street, Suite 100 Indianapolis, IN 46202 For additional information please contact Grisel Barajas, ILI Education Program and Communication Coordinator, at 317-472-1055 or [email protected].

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Indiana Latino Institute Fellowship Program www.indianalatinoinstitute.org

Full Name: _______________________________________ D.O.B.: _____________ Age: ________

(First) (Last) (Month/Day/Year)

Country of Birth: ____________________________________ Ethnic Origin: ______________________ (Ex. Mexican, Salvadoran, Colombian, etc.)

How many years have you lived in the United States? ______________ Home Address: _______________________________________________________________________

City, State and Zip Code: ________________________________________________________________

Phone 1: _____________________________________ Phone 2: _______________________________

Email 1: ___________________________________ Email 2: __________________________________ (Please list an email address that you check regularly, as it is required to respond to our messages in order to be considered for the internship.) Is your father currently employed? Yes No Don’t know Is your mother currently employed? Yes No Don’t know

What is your family’s total annual income? ______________________

How many people live in your home; including yourself? __________

Do you have a valid Indiana driver’s license? Yes No

What is your current citizenship status?

U.S. Citizen U.S. Permanent Resident DACA (Deferred Action for Childhood Arrivals) TPS (Temporary Protected Status) U-VISA Other: ______________________

Name of Emergency Contact: _______________________________ Relationship to you: ____________

Address: ____________________________________________________________________________

Phone 1: ____________________________________ Phone 2: ________________________________

SE SECTION I. Applicant Information

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Indiana Latino Institute Fellowship Program www.indianalatinoinstitute.org

College/University Information: College/University Name: ___________________________________ Currently Enrolled: Yes No

Anticipated Graduation: ______________ Cumulative GPA: ____________ Major GPA: ______________

Major: _______________________________________ Minor: __________________________________

Are you eligible to receive financial aid from FAFSA? Yes No (Must be considered U.S. Citizen or eligible non-citizen) Have you filled out a FAFSA application for 2017-2018? Yes No Are you a first-generation college student? Yes No

Are you a participant in the 21st Century Scholars program? Yes No

Have you applied for any of the following scholarships? Please check all that apply. Received?

Indiana Latino Institute Yes No La Plaza Yes No Mexican Scholarship Fund Yes No SADCO Yes No

Will you be receiving any scholarships for the 2017 Fall Semester? Yes No

If yes, please list here: _________________________________________________________________

2017 Summer Semester: Will you be attending a college or university in the state of Indiana for the 2017 summer semester? Y N

College/University Name: _______________________________________________________________

Number of Credit Hours: _______________ Which tuition rate are you paying? In-state Out-of-state

2017 Fall Semester: Will you be attending a college or university in the state of Indiana for the 2017 Fall Semester? Y N (If no, skip this section)

Name of College/University: _________________________________ Number of Credit Hours: ________

Major: ________________________________ Which tuition rate will you pay? In-state Out-of-state

SE SECTION II. Education

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Indiana Latino Institute Fellowship Program www.indianalatinoinstitute.org

Please list the last two places you have worked starting with the most recent.

1. Company: ______________________________________ Company Phone: __________________

Job Title: ______________________ Start Date: ____________ End Date: __________________

Supervisor: __________________________ May we contact your supervisor as reference? Y N

2. Company: ______________________________________ Company Phone: __________________

Job Title: ______________________ Start Date: ____________ End Date: _________________

Supervisor: ________________________ May we contact your supervisor as a reference? Y N

References: Please list three references that are not considered family members. (Ex. Counselor, professor, coach, employer, mentor, etc.)

1. Full Name: _____________________________ Phone Number: ____________________________ 2. Full Name: _____________________________ Phone Number: ____________________________ 3. Full Name: _____________________________ Phone Number: ____________________________

Do you have a job lined up for the summer? Yes No

Where? _____________________________________________ Number of Hours/Week: ___________

Anticipated Schedule: (Ex. Mondays and Wednesdays from 3:00pm to 5:00pm) ____________________________________________________________________________________

Write a 1-2 page essay about what you consider your most significant professional, volunteer, or academic accomplishment as it relates to your professional interest. In addition, discuss your professional goals what personally motivates you to pursue this career path. This essay must be typed and double spaced with 12-point font and one-inch margins. Essays must be the original work of the student applying for the program. Please email the completed essay to [email protected] or include it with the completed application

Applicants must submit at least two recommendation letters. These letters of recommendation must be from an employer, professor, mentor, advisor, or other individual who can speak to your background and character. Letters cannot be submitted by family members or friends. Letters should include the contact information and title of the person submitting the letter. We strongly encourage you to request letters from individuals that can speak to your professional competence and accomplishments, community and civic activities, or educational accomplishments. Letters can be attached to application materials or emailed to [email protected].

SE SECTION III. Employment

SE SECTION IV. Essay

SE SECTION V. Recommendation Letters

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Indiana Latino Institute Fellowship Program www.indianalatinoinstitute.org

Please include your curriculum vitae or resume with your application. This can be attached to application materials or emailed to [email protected].

Please submit a Limited Criminal History Background Check. This can be attached to application materials or emailed to [email protected].

Orientation: Each ILI fellow must attend a 3-day orientation before the start of their fellowship. Please confirm that you are available on the following dates. 1. Monday, June 12th from 9:00am -3:00pm: Yes No

2. Tuesday, June 13th from 9:00 am-3:00pm: Yes No

3. Wednesday, June 14th from 9:00am – 3:00pm: Yes No

Transportation: Do you have reliable transportation to and from your fellowship site? (Please include a back-up form of transportation if your parents are your main means of transportation.) Yes No

If yes, please explain: __________________________________________________________________

If no, please explain: ___________________________________________________________________

Special Obligations and or Activity Limitations: Are there any obligations that should be considered in planning a placement (childcare, employment, ill family members, etc.)? Yes No

If yes, please explain: __________________________________________________________________

Do you have any physical or other conditions that would limit your activity or which should be considered in planning placement? (Proper accommodations will be made for students with physical limitations) Yes No

If yes, please explain: __________________________________________________________________

I certify that my answers are true and complete to the best of my knowledge. If this application leads to a fellowship opportunity, I understand that false or misleading information in my application or interview may result in my release. The Indiana Latino Institute will only provide a copy of this application to your chosen fellowship site for their review.

Signature: ____________________________________________ Date___________________________

SE SECTION VIII. Fellowship Information

SE SECTION VI. Curriculum Vitae or Resume

SE SECTION VII. Background Check

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2017 Summer Internship Application

Purpose The purpose of the Indiana Latino Institute Summer Internship is to connect Indiana Latino students with professional development opportunities. Students will receive a scholarship for completing all requirements of the summer internship program. Internship Eligibility Requirements

Open to students who are graduating high school seniors through college seniors, who are between age 18-25

Must enroll at a college/university in the state of Indiana at least part time for fall 2017 semester

Must participate in mandatory training on June 12, 2017—June 14, 2017 Intern must be available to do internship in Indianapolis Preference is given to ILI program participants

Benefits of Internship Program

Work alongside professionals Build professional network Receive educational scholarship Gain 125 hours of experience in field of study Possible employment

Intern Selection Process Internship applicants must submit the following documents by April 28, 2017:

Internship application Resume Unofficial transcript

Potential interns will be interviewed by ILI. Interviews and strength of documents will be considered when selecting interns for the ILI Internship Program.

Program Dates June 1, 2017—August 18, 2017 Application Deadline All application materials must be postmarked and mailed to the address below by April 28, 2017. Attn: Grisel Barajas Indiana Latino Institute 401 W. Michigan Street, Suite 100 Indianapolis, IN 46202 Or via email to: [email protected] For additional information please contact Grisel Barajas, ILI Education Program and Communication Coordinator at [email protected] or (317) 472-1055.

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Full Name: _______________________________________ D.O.B.: _____________ Age: ________

(First) (Last) (Month/Day/Year)

Country of Birth: ____________________________________ Ethnic Origin: ______________________ (Ex. Mexican, Salvadoran, Colombian, etc.)

How many years have you lived in the United States? ______________ Home Address: _______________________________________________________________________

City, State and Zip Code: ________________________________________________________________

Phone 1: _____________________________________ Phone 2: _______________________________

Email 1: ___________________________________ Email 2: __________________________________ (Please list an email address that you check regularly, as it is required to respond to our messages in order to be considered for the internship.) Is your father currently employed? Yes No Don’t know Is your mother currently employed? Yes No Don’t know

What is your family’s total annual income? ______________________

How many people live in your home; including yourself? __________

Do you have a valid Indiana driver’s license? Yes No

What is your current citizenship status?

U.S. Citizen U.S. Permanent Resident DACA (Deferred Action for Childhood Arrivals) TPS (Temporary Protected Status) U-VISA Other: ______________________

Name of Emergency Contact: _______________________________ Relationship to you: ____________

Address: ____________________________________________________________________________

Phone 1: ____________________________________ Phone 2: ________________________________

SE SECTION I. Applicant Information

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High School: Name of High School: __________________________________________________________________

Graduation Date: _________ GPA: __________ Diploma: Honors Core 40 Other: _____________

Did you receive free or reduced lunch (K-12): Yes No

Are you participating in the Project Stepping Stone Program this summer: Yes No

Are you participating in the Latino Youth Collective (Campesine Academy) Program this summer: Y N

College/University Information: College/University Name: ______________________________________ Currently Enrolled: Yes No

Anticipated Graduation: ______________ Cumulative GPA: ____________ Major GPA: ______________

Major: _______________________________________ Minor: __________________________________

Are you eligible to receive financial aid from FAFSA (Must be considered U.S. Citizen or eligible non-citizen)? Yes No

Have you filled out a FAFSA application for 2017-2018? Yes No

Are you a first-generation college student? Yes No

Are you a participant in the 21st Century Scholars program? Yes No

Have you applied for any of the following scholarships? Please check all that apply. Received?

Indiana Latino Institute Yes No La Plaza Yes No Mexican Scholarship Fund Yes No SADCO Yes No

Will you be receiving any scholarships for the 2017 Fall Semester? Yes No

If yes, please list here: _________________________________________________________________

2017 Summer Semester: Will you be attending a college or university in the state of Indiana for the 2017 summer semester? Y N

College/University Name: _______________________________________________________________

Number of Credit Hours: _______________ Which tuition rate are you paying? In-state Out-of-state

2017 Fall Semester: Will you be attending a college or university in the state of Indiana for the 2017 Fall Semester? Yes No (If no, skip this section)

Name of College/University: _________________________________ Number of Credit Hours: ________

Major: ________________________________ Which tuition rate will you pay? In-state Out-of-state

SE SECTION II. Education

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Please list the last two places you have worked; starting with the most recent: 1. Company: ______________________________________ Company Phone: __________________

Job Title: ______________________ Start Date: ____________ End Date: __________________

Supervisor: __________________________________ May we contact them as reference? Y N

2. Company: ______________________________________ Company Phone: __________________

Job Title: ______________________ Start Date: ____________ End Date: _________________

Supervisor: ________________________________ May we contact them as a reference? Y N

References: Please list three references that are not considered family members. (Ex. Counselor, employer, mentor, etc.): 1. Full Name: _____________________________ Phone Number: ____________________________

2. Full Name: _____________________________ Phone Number: ____________________________

3. Full Name: _____________________________ Phone Number: ____________________________

Do you have a job lined up for the summer? Yes No

Where? _____________________________________________ Number of Hours/Week: ___________

Anticipated Schedule: (Ex. Mondays and Wednesdays from 3:00pm to 5:00pm)

____________________________________________________________________________________

Please include your resume and unofficial transcript with your application. These can be attached to the application or emailed to [email protected].

Orientation: Each ILI intern must attend a 3-day orientation before the start of their fellowship. Please confirm that you are available on the following dates. 1. Monday, June 12th from 9:00am -3:00pm: Yes No

2. Tuesday, June 13th from 9:00 am-3:00pm: Yes No

3. Wednesday, June 14th from 9:00am – 3:00pm: Yes No

SE SECTION III. Employment

SE SECTION V. Internship Information

SE SECTION IV. Additional Documents

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Transportation: Do you have reliable transportation to and from your internship site? (Please include a back-up form of transportation if your parents are your main means of transportation.) Yes No

If yes, please explain: __________________________________________________________________

If no, please explain: ___________________________________________________________________

Special Obligations and or Activity Limitations: Are there any obligations that should be considered in planning a placement (childcare, employment, ill family members, etc.)? Yes No

If yes, please explain: __________________________________________________________________

Do you have any physical or other conditions that would limit your activity or which should be considered in planning placement? (Proper accommodations will be made for students with physical limitations) Yes No

If yes, please explain: __________________________________________________________________

I certify that my answers are true and complete to the best of my knowledge. If this application leads to a internship opportunity, I understand that false or misleading information in my application or interview may result in my release. The Indiana Latino Institute will only provide a copy of this application to your chosen internship site for their review.

Signature: ____________________________________________ Date___________________________

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Indiana Latino Institute Scholarship Program www.indianalatinoinstitute.org

2017 SCHOLARSHIP PROGRAM About The Indiana Latino Institute scholarship was created as a means to address the underrepresentation of Latinos in post-secondary education. The goal is to encourage Latino students in Indiana to pursue higher education and engage in community service. In order to accomplish this goal, ILI will provide scholarships for the 2017-2018 academic year. Eligibility:

Students must be planning to enroll in a minimum of 6 credit hours per semester in the 2017-2018 academic year

Students must be between the ages of 17 and 25 at the time of submitting application Demonstrate academic achievement (minimum 2.7 GPA on 4.0 scale) Demonstrate financial need (complete financial need form) Document ongoing community service involvement Preference given to Latino students residing in Indiana who are first generation college students

Deadline: All application materials including essay, letters of recommendation, official transcripts, and all other requirements must be postmarked and mailed to the address below by May 26, 2017. Notification: Award letters will be sent to scholarship recipients by June 30, 2017. Send Applications to: Attn: Indiana Latino Scholarship Committee Indiana Latino Institute 401 W. Michigan Street, Suite 100 Indianapolis, IN 46202 Questions Questions about the scholarship should be directed to Grisel Barajas at [email protected] or (317) 472-1055

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Indiana Latino Institute Scholarship Program www.indianalatinoinstitute.org

2017 SCHOLARSHIP APPLICATION

APPLICANT INFORMATION Full Name: Date of birth: Place of Birth: Ethnicity/Latino Heritage:

Permanent Address: City: State: Zip Code: Primary Phone: Alternate Phone: Email Address:

EMERGENCY CONTACT Name: Address: City: State: Zip Code: Relationship: Primary Phone: Alternate Phone:

EDUCATIONAL BACKGROUND Name of high school enrolled/graduated: City, State, and Zip Code: Graduation Date:

GPA:

Type of Degree Attained (Core 40, Academic Honors, GED, etc.):

Have you ever attended any ILI Events? Yes No If Yes, please specify (Legislative Breakfast, Education Summit, etc.): Are you enrolled in ILI’s College Coaching program? Yes No Are you a first generation college student? * Yes No *First generation college student is defined as a student with neither parent having any education beyond high school. What college or university are you planning on or currently attending? Student ID (College, if applicable): Course of Study (Major): What is your expected date/year of graduation? Estimated cost of post-secondary tuition in 2016-2017:

Have you made a decision about your future career interest or occupation? Yes No If Yes, please specify:

COMMUNITY SERVICE AND EXTRACURRICULAR ACTIVITIES

Please submit a list of community service, volunteer work, club participation, sports, work, etc. Be sure to include dates of involvement, leadership positions held, and time commitment of each activity. Be sure to properly identify each activity as either volunteer or paid.

ESSAY/PERSONAL STATEMENT

Write an essay to tell us more about yourself and your goals or interests in a particular field of study. Include information about how your ethnic origin, academic journey, financial need, or other barriers have influenced your goals or motivated you to pursue a field. Essay must be 1-2 pages, single spaced, typed, 12-point font size, Times New Roman font and must be written in English.

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Indiana Latino Institute Scholarship Program www.indianalatinoinstitute.org

ILI FINANCIAL NEED FORM 2016-2017

Section A — Student Information: Are you currently employed? Yes No Do you plan to work during the 2017-2018 academic year? Yes No On average, how many hours per week do you work? ____________ Which best describes your living situation (or anticipated living situation) while in college? Dorms/On-Campus With Parents Off-Campus Other: _______________________ Monthly Housing Costs: __________________________ Section B — Family Information: Total number of people who live in your household (Include all of the people living with you): _______ Indicate the ages and your relationship (father, mother, sibling, cousin, grandparent, etc.) with all of the people living in your family’s household:

Name Relationship Age Enrolled in college for 2017-2018 academic year?

Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No

How many of the above family members will attend college as a full time undergraduate student during the 2017-2018 academic year? ________________ How many of the above family members are employed? ________________ Section C —Financial Information: (Do not leave any spaces blank). Income earned from work by father in 2016: $_____________ Income earned from work by mother in 2016: $_____________ Income earned by student in 2016: $_____________ Does the family qualify for Public Assistance Program? Yes No Did the family complete an Income Tax Return for last year? Yes No What was the family’s taxable household income for 2016? $_____________ How many persons were dependent upon your household income for this past year? ________ Please explain and list any income not listed above (TANF, disability, child support, etc.): ____________________________________________________________________________________________________________________________________________________________________________________

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Indiana Latino Institute Scholarship Program www.indianalatinoinstitute.org

Are you enrolled in the 21st Century Scholars program? Yes No Are you eligible to apply for the Free Application for Federal Student Aid (FAFSA)? Yes No If yes, have you applied for FAFSA for the 2017-2018 academic year? Yes No N/A (Please include a copy of your FAFSA if you have applied.) Did you receive any institutional aid from the college/university you plan to attend? Yes No If yes, how much did you receive? ______________________ Have you applied for any other scholarships? Yes No Please list all scholarships you have applied for below:

Name of Scholarship Award Amount Received? Yes No Unknown Yes No Unknown Yes No Unknown Yes No Unknown Yes No Unknown Yes No Unknown Yes No Unknown Yes No Unknown Yes No Unknown Yes No Unknown

Anticipated College/University Payment Plan: Contribution from parents: $_______________ Contribution from student: $_______________ College/University Scholarship: $_______________ Private Scholarships: $_______________ Government Grants: $_______________ Other (Please identify source): $_______________ I have read and understand all the questions contained in this application. I certify that all the information that I have provided is complete and accurate to the best of my knowledge. I understand that any misrepresentation may be cause for refusing or revoking the granted scholarship. Student Printed Name: __________________________________________________________________________________ Signature: __________________________________________________________________________________

(Student) (Date signed) Signature: __________________________________________________________________________________

(Parent) (Date signed)

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Indiana Latino Institute Scholarship Program www.indianalatinoinstitute.org

APPLICATION REQUIREMENTS CHECKLIST □ Completed Application Form □ Community Service/Extracurricular Activities List □ Essay/Personal Statement □ Completed Financial Need Form □ Transcript of grades: Include an official transcript from your current high school or college □ Letter of Recommendation:

Please include (1) letter of recommendation from a teacher/professor, guidance counselor/advisor, or community service supervisor in a sealed envelope.

□ If you have applied for financial aid, include a copy of your FAFSA or Student Aid Report. □ Please submit all items in one envelope properly addressed to ILI and postmarked no later than May 26, 2017

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TO APPLY, VISIT

http://www.martin.edu/financial-aid or the Financial Aid office for an application.

Application deadline is

Saturday, May 6, 2017.

Submit your completed application to Doraine Reynolds-Malone in the Office of Academic Affairs or by e-mail to [email protected].

The award will be made for the 2017 Fall Semester.

For additional information, contact Doraine Reynolds-Malone, at 317.543.4890 or [email protected]

 

 

Dr. James Trippi is an Indianapolis-based cardiologist who founded the Gennesaret Free Clinic. He is passionate about serving others, particularly those who may be at a disadvantage. Dr. Trippi has graciously established an annual $1,000 scholarship at Martin University to be awarded to an eligible junior or senior undergraduate student. The current award is for the 2017 Fall Semester.

Topic: Importance of education for you and your community

See Essay requirements for ALL scholarships located on FA webpage under scholarships.

Eligibility requirements include:

Junior or Senior class standing (61+ earned credit hours)

Minimum overall GPA of 3.0 or higher In good standing at the University Community service involvement Completed the FAFSA

Completed applications will be reviewed by an award committee.

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Fellowships Disability Research Consortium

A cooperative agreement with the Social Security Administration

Fellowships

Mathematica is offering two fellowship programs to graduate students in 2017.

The summer fellowship program is an opportunity for students in master’s programs or early in doctoral programs (pre-dissertation phase) to spend the summer of 2017 at Mathematica’s Washington, DC, office to learn more about conducting an independent research project related to disability policy. Get information about the eligibility requirements and application process.

Read more about summer fellows from recent years and examples of successful applications in recent years.

For questions regarding the summer fellows program, please email [email protected].

The dissertation fellowship program will offer financial support to students conducting their doctoral dissertation research on topics consistent with the DRC’s mission. In contrast with the summer fellows program, dissertation fellows will remain at their home institution, with financial support provided to continue cutting-edge dissertation research. Get information about the eligibility requirements and application process.

Read more about our 2016 dissertation fellows and examples of successful applications in recent years.

For questions regarding the dissertation fellowship program, please email [email protected].

Mathematica Policy Research P.O. Box 2393, Princeton, NJ 08543-2393 P: 609.799.3535 F: 609.799.0005 [email protected]

 

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Federal Student Aid TEACH Grant Program What is the TEACH Grant Program? The Teacher Education Assistance for College and Higher Education (TEACH) Grant Program provides grants of up to $4,000 per year to students who agree to teach for four years at an elementary school, secondary school, or educational service agency that serves students from low-income families and to meet other requirements. The terms and conditions of this teaching service obligation are explained in the TEACH Grant Agreement to Serve that you must sign before you receive a TEACH Grant (see "What is the TEACH Grant Agreement to Serve?" below).

IMPORTANT: If you do not complete your service obligation, all TEACH Grant funds you received will be converted to a Direct Unsubsidized Loan. You must then repay this loan to the U.S. Department of Education (ED), with interest charged from the date the TEACH Grant was disbursed (paid out).

What are the eligibility requirements? To receive a TEACH Grant, you must:

• Meet the general eligibility requirements for the federal student aid programs as described at StudentAid.gov/eligibility/basic-criteria.

• Complete the Free Application for Federal Student Aid (FAFSA®).

• Be enrolled as an undergraduate, postbaccalaureate, or graduate student at a school that participates in the TEACH Grant Program.

• Be enrolled in a TEACH-Grant-eligible program.

Meet certain academic achievement requirements (generally, scoring above the 75th percentile on one or more portions of a college admissions test or maintaining at least a 3.25 cumulative grade point average).

• Receive counseling (on ED's TEACH Grant page at https://studentloans.gov/myDirectLoan/launchTeach.action) that explains the terms and conditions of the TEACH Grant service obligation.

• Sign a TEACH Grant Agreement to Serve.

What is a TEACH-Grant-eligible program? A TEACH-Grant-eligible program is a program of study that is designed to prepare you to teach as a highly qualified teacher in a high-need field and that leads to a bachelor's or master's degree, or is a post- baccalaureate program. A two-year program that is acceptable for full credit toward a bachelor's degree is considered a program that leads to a bachelor's degree. A postbaccalaureate program is a program for students who have already earned a bachelor's degree that (1) does not lead to a graduate degree, (2) is treated as an undergraduate program, and (3) consists of courses required by a state in order for you to receive a certification or license to teach in an elementary or secondary school in that state. A postbaccalaureate program is not TEACH-Grant-eligible if it is offered by a school that also offers a bachelor's degree in education.

Schools that participate in the TEACH Grant Program determine which of the programs they offer are TEACH-Grant-eligible. A program that is TEACH-Grant-eligible at one school might not be TEACH-Grant-eligible at another school. Contact the financial aid office at the school you are attending (or that you plan to attend) to find out which programs at that school are eligible.

Page 1 of 3

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What is the TEACH Grant Agreement to serve?

Each year that you receive a TEACH Grant, you must sign an Agreement to Serve on ED's TEACH Grant page at https://studentloans.gov/myDirectLoan/launchTeach.action. The TEACH Grant Agreement to Serve explains the terms and conditions of the service obligation you must agree to fulfill as a condition for receiving a TEACH Grant. By signing the Agreement to Serve, you agree to these terms and conditions and acknowledge your understanding that if you do not fulfill the service obligation, the TEACH Grant funds you received will be converted to a loan that you must repay.

What are the terms and conditions of the TEACH Grant service obligation? In exchange for receiving a TEACH Grant, you must agree to the following:

• For each TEACH-Grant-eligible program for which you receive TEACH Grant funds, you must serve as a full-time teacher for a total of at least four academic years within eight years after you complete or otherwise cease to be enrolled in the program for which you received the TEACH Grant.

• You must perform the teaching service as a highly qualified teacher at a low-income school or educational service agency. The term "highly qualified teacher" is defined in Section 9101(23) of the Elementary and Secondary Education Act of 1965 and in Section 602(10) of the Individuals with Disabilities Education Act.

• Your teaching service must be in a high-need field.

• You must provide ED with documentation of your progress toward completing your service obligation.

• If you do not meet the requirements of your service obligation, all TEACH Grant funds you received will be converted to a Direct Unsubsidized Loan. You must repay this loan in full, with interest charged from the date of each TEACH Grant disbursement.

What are high-need-fields? High-need fields are bilingual education and English language acquisition, foreign language, mathematics, reading specialist, science, and special education, as well as any other field that has been identified as high-need by the federal government, a state government, or a local education agency, and that is included in ED's annual Teacher Shortage Area Nationwide Listing (Nationwide List).If you are planning to teach in a high-need field that is included in the Nationwide List, that field must be listed for the state where you teach either at the time you begin your qualifying teaching service or at the time you received a TEACH Grant. To access the Nationwide List, visit www.ed.gov/about/offices/list/ope/pol/tsa.doc.

How can I identify schools or educational service agencies that serve low-income students? Elementary and secondary schools (public and private) and educational service agencies serving low-income students are listed in ED’s annual “Teacher Cancellation Low-Income Directory.” To access the directory, visit https://tcli.ed.gov and click on the "Search" button. In addition, elementary or secondary schools operated by the Department of the Interior's Bureau of Indian Education (BIE) or operated on Indian reservations by Indian tribal groups under contract or grant with the BIE qualify as low-income schools.

Can a TEACH Grant service obligation ever be suspended or canceled? You may request a temporary suspension of the eight-year period for completing your TEACH Grant service obligation based on:

• Your enrollment in a TEACH-Grant-eligible program or your enrollment in a program that a state requires you to complete in order to receive a certification or license to teach in that state's elementary or secondary schools.

Federal Student Aid | StudentAid.gov Page 2 of 3

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For example, if you received a TEACH Grant for an undergraduate program and you later enroll in a graduate program for which you would be eligible to receive a TEACH Grant, you could receive a suspension of the eight-year period for completing your service obligation for the undergraduate program while you are enrolled in the graduate program.

• A condition that is a qualifying reason for leave under the Family and Medical Leave Act (FMLA).

• A call or order to active duty status for more than 30 days as a member of the armed forces reserves, or service as a member of the National Guard on full-time National Guard duty under a call to active service in connection with a war, military operation, or national emergency.

Suspensions are granted in one-year increments, not to exceed a combined total of three years for the first two conditions listed above, or a total of three years for the third condition. If you receive a

suspension, the eight-year period for completing your service obligation is put "on hold" during the suspension period. For example, if you receive a one-year suspension after two years of the eight-year period for completing your service obligation have elapsed, you would have six years left to complete your service obligation when the one-year suspension period ends.

Your TEACH Grant service obligation may be canceled (discharged) if you die or if you become totally and permanently disabled. You may also receive a discharge of some or all of your four-year teaching requirement if you are called or ordered to qualifying military active duty for a period that exceeds three years.

If I’m interested in receiving a TEACH Grant, where can I get more information? Contact the financial aid office at the school where you will be enrolled to find out whether the school participates in the TEACH Grant Program and to learn about the programs of study at the school that are TEACH-Grant-eligible.

.

October 2016

Federal Student Aid | StudentAid.gov Page 3 of 3


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