Class of 2017 HWNT-FW Scholarship Application

Promotes the advancement of women through public, corporate, and civic life.

Latinas In Progress™ (LIP) Education Series SCHOLARSHIP APPLICATION  DEADLINE: FEBRUARY 18, 2017

PLEASE USE BLACK INK

To apply for a scholarship, you must be a Latina and a Senior in high school who has attended all five sessions of the HWNT-FW Latinas in Progress™ (LIP) Education Series, in addition to meeting the requirements outlined in this application. (If a makeup session is completed, you must include the documentation with this application packet.)

I. PERSONAL DATA

Name: (Last) (First) (Middle)

Address: (Street) (City) (Zip) Cell/Home Phone: Email address:

High School:

Parents’ Names: (Father) (Mother)

Number of Children at Home: Number of Children in College:

Father’s Occupation: Mother’s Occupation:

Family’s Gross Annual Income: (Total of Parents’ income before taxes, plus any other sources of income)

Are you currently employed? If yes, where?

Why are you working and on average, how many hours per week do you work?

HWNT Fort Worth Chapter  PO BOX 1523 Fort Worth, Texas 76101  www.hwntfw.org Copyright © 2012-16 Hispanic Women’s Network of Texas  All Rights Reserved 1 Class of 2017 HWNT-FW Scholarship Application

II. ACADEMIC PERFORMANCE

1. Class Rank: out of graduating seniors

2. WEIGHTED GPA: on a scale of (Indicate if you are on a 4.0 scale or other scale)

3. Enclose an official transcript with this application.

4. SAT Score: Math Reading Writing Total

ACT Score:

Please attach a copy of your SAT and/or ACT scores. Only one test score is required for this scholarship application.

III. SCHOOL AND COMMUNITY INVOLVEMENT 1. Please list extracurricular school activities or organizations to which you belong. (Use a separate sheet if needed)

HWNT Fort Worth Chapter  PO BOX 1523 Fort Worth, Texas 76101  www.hwntfw.org Copyright © 2012-16 Hispanic Women’s Network of Texas  All Rights Reserved 2 Class of 2017 HWNT-FW Scholarship Application

2. Please list activities or organizations outside of school to which you belong. (Don’t forget to include the Class of 2017 Latinas in Progress Education Series! (Use a separate sheet if needed)

3. What honors, recognition, or awards have you received? (Use a separate sheet if needed)

IV. COMMUNITY SERVICE

Please provide proof or documentation that you have completed a minimum of 12 hours of community service during the 2016-17 school year that was completed prior to the scholarship application deadline. A minimum of 12 hours is required for this scholarship application but

HWNT Fort Worth Chapter  PO BOX 1523 Fort Worth, Texas 76101  www.hwntfw.org Copyright © 2012-16 Hispanic Women’s Network of Texas  All Rights Reserved 3 Class of 2017 HWNT-FW Scholarship Application feel free to include ALL hours of service from the 2016-17 school year. Don’t forget to indicate volunteer hours with HWNT. Some examples of acceptable community service include: HWNT, church, hospital, food bank, senior citizen center, Red Cross, YWCA, library, neighborhood association, middle or elementary school, etc. An example of unacceptable community service hours include: Helping out with a family business

V. REFERENCES

Please list three personal references. References can be teachers, counselors, employers, ministers, or activity/organization leaders, etc. (References from family members, friends, or close acquaintances are not allowed.) Please ask each of your references to complete the Reference Form. Be sure to include your name, address, and phone number on the Reference Form before you give the forms to your references. Your reference should return a sealed and completed Reference Form for you to submit to HWNT Scholarship Committee by the required deadline. An optional letter of recommendation may be included with the form. (Your reference can also mail their completed Reference Form directly to the Scholarship Chair at the address listed on the form.)

1. (Name) (Address) (Telephone)

2. (Name) (Address) (Telephone)

3. (Name) (Address) (Telephone)

VI. ESSAY

Please type a minimum one full-page essay on the following topic using LIP Education Series Guidelines for Essay Writing. And please follow these guidelines as well: (12pt. Times New Roman font, 1 in margins, between 500-700 words)

Topic: Tell us about the most significant person, experience, or circumstance which has shaped your life thus far. How has she, he, or it influenced your character? How might you use what you have learned to achieve your goals?

HWNT Fort Worth Chapter  PO BOX 1523 Fort Worth, Texas 76101  www.hwntfw.org Copyright © 2012-16 Hispanic Women’s Network of Texas  All Rights Reserved 4 Class of 2017 HWNT-FW Scholarship Application

VII. COLLEGE/UNIVERSITY PLANS

You must have applied to the appropriate university before our scholarship deadline in order to be considered for either the TCU Community Scholar Award or the Texas Wesleyan Scholarship.

Which HWNT-FW Scholarship Awards are you interested in receiving? Application Status: Check box of Scholarship Name Description Have you applied? Scholarship(s) you (Indicate Yes or No) wish to receive FULL tuition, 4 years TCU Community Scholar (GPA & other requirements apply Award for annual renewal)  2 students will receive $5,000 each to be used for the 2017-2018  academic year. This can be renewed for 8 consecutive semesters Texas Wesleyan Scholarship (GPA & other requirements apply for renewal) Note: award amount may be revised based on receipt of other financial assistance. Monetary award that can be used at ANY college/university for one HWNT-FW Scholarship year and/or can be used for N/A  reimbursement of tuition, fees, school supplies, books, etc.

What other scholarships have you applied for? ______

Which other scholarships have you received? ______

What are your career interests and intended field of study? ______

HWNT Fort Worth Chapter  PO BOX 1523 Fort Worth, Texas 76101  www.hwntfw.org Copyright © 2012-16 Hispanic Women’s Network of Texas  All Rights Reserved 5 Class of 2017 HWNT-FW Scholarship Application

HWNT Fort Worth Chapter  PO BOX 1523 Fort Worth, Texas 76101  www.hwntfw.org Copyright © 2012-16 Hispanic Women’s Network of Texas  All Rights Reserved 6 Class of 2017 HWNT-FW Scholarship Application

Please select the colleges or universities where you have applied and indicate whether you have been accepted:

1st Choice Name of School: Have you applied? Yes No Have you been accepted? Yes No

2nd Choice Name of School: Have you applied? Yes No Have you been accepted? Yes No

3rd Choice Name of School: Have you applied? Yes No Have you been accepted? Yes No

VIII. HWNT SCHOLARSHIP AGREEMENT

I understand that any money awarded to me will be paid directly to the accredited institution I have chosen to attend OR will be reimbursed to me after I show proof of tuition payment. I must enroll for a minimum of twelve college hours or vocational equivalent per semester (full-time student status.) Funds will be for tuition, books, and school-billed fees. I understand that it is my responsibility to request funds in a timely manner from HWNT so that they can be paid to my academic institution prior to any payment deadlines. (Please allow one week for scholarship fund processing.)

The Scholarship Committee will review each application on an individual basis. Each application will be reviewed and scored by three members of the committee. If a student has a mentor or a relative who is on the Scholarship Committee, the mentor or relative will not be allowed to evaluate that application. The committee’s decisions will be final and reviewed by the Scholarship Chair prior to notification of any award recipient. Failure to submit a complete 2016 Scholarship Application may cause the Scholarship Chair and/or committee to disqualify the application completely.

Scholarships will be awarded on a one-time basis for the upcoming school year and funds must be used within one calendar school year. I understand that if I do not enroll or if I withdraw from school during the time frame the scholarship was issued, any unused money will be returned to the Scholarship Fund of the Hispanic Women’s Network of Texas – Fort Worth Chapter. I also understand that any additional scholarship requirements of my academic institution must be met and maintained in order to receive my scholarship.

I certify that all my responses are true and factual. If selected as an HWNT scholarship award recipient, I will make efforts to give back to the LIP Education Series by volunteering at future sessions, being available to future LIP students for interviews, or special appearances at other HWNT-FW events. In addition, I will also keep the HWNT Education and Scholarship Chairs informed and updated with my address and contact information.

HWNT Fort Worth Chapter  PO BOX 1523 Fort Worth, Texas 76101  www.hwntfw.org Copyright © 2012-16 Hispanic Women’s Network of Texas  All Rights Reserved 7 Class of 2017 HWNT-FW Scholarship Application

(Signature of Applicant) (Date)

HWNT Fort Worth Chapter  PO BOX 1523 Fort Worth, Texas 76101  www.hwntfw.org Copyright © 2012-16 Hispanic Women’s Network of Texas  All Rights Reserved 8 Class of 2017 HWNT-FW Scholarship Application

2017 HWNT SCHOLARSHIP APPLICATION CHECKLIST *** IMPORTANT***

All of the following are required for submission of a complete application for review by the HWNT Scholarship Committee. Make sure you include the following in your packet:

 Completed Application

 Essay

 Official Transcript

 Copy of SAT and/or ACT scores

 Documentation for Community Service

 Reference Form #1

 Reference Form #2

 Reference Form #3

 Make a hard copy or electronic copy of your packet to keep for your records

DEADLINE TO SUBMIT YOUR COMPLETED SCHOLARSHIP APPLICATION: IN PERSON OR BY MAIL IS FEBRUARY 18, 2017

You have 2 options to turn in your HWNT Scholarship packet. Either option listed below is acceptable:

1. Bring your completed application materials to the Scholarship Chair at the last LIP Education Series session on February 18, 2017, the Assertive Latina session at Texas Wesleyan University.

2. Mail in your completed scholarship application packet which must be postmarked by February 18, 2017 to:

HWNT Fort Worth Chapter Scholarship Chair PO Box 1523 Fort Worth, Texas 76101

Questions or for more information, contact the HWNT Scholarship Chair (Evalis Chapa until 12/31/16 and Cynthia Montes beginning 1/1/17) at [email protected]