Diane H. Thomas Scholarship for Phoenix College Alumni The ...
Diane H. Thomas Scholarship for Phoenix College Alumni The ... Diane H. Thomas Scholarship for Phoenix College Alumni The ...
Applicant information: Name (Last, First, M.I.) Student ID #___________________________________________________________ Email_________________________________________________________________ Address_______________________________________________________________ City, State & Zip_________________________________________________________ Telephone (best number to reach you)_______________________________________ Check those that apply to you: I am a first generation college student (You are a first generation college student if both parents or guardians [parent or guardian if only living with one] did not complete a bachelor’s degree) Yes____ No____ I am an adult returning to college (21 years or older) Yes____ No____ I am seeking a(n): ____Associate’s Degree (Projected completion date:________) ____Certificate (Projected completion date:________) ____Plan to transfer to ______________________________by__________ Name of institution (mm/yy) ____Bachelor’s Degree (Projected completion date:________) ____Other (explain):____________________________________________ Major/Academic program of study:_________________________________ Currently enrolled in college? Yes_____ (If yes, complete next section) No____ I am currently attending __________________________________, where I have accumulated_____credit hours (list total # of credit hours earned after current semester) and my cumulative GPA is_____. I plan to attend______________________ for the ___________________, _______ semester and register for __________ credit spr./sum/fall yr. hours.
When do you anticipate graduating or completing your studies at Phoenix College? Are you currently employed? Yes____ No____ If yes, describe your employment situation (i.e., full-time, part-time, etc.). List any scholarships or financial aid you are or will be receiving (state amount, sources, and dates): Your responses to the following are optional and are gathered for statistical and informational purposes only: Are you: Single____ Married____ Single Parent____ Gender: Female____ Male____ Ethnicity: American Indian/Alaskan Native____ Hispanic____ Asian or Pacific Islander____ White, not of Hispanic origin____ Black, not of Hispanic origin____ Other____ Date of birth:_________________(mm/dd/yy) Phoenix College, a part of the Maricopa Community College District, does not discriminate on the basis of race, color, religion, national origin, sex, sexual orientation, handicap/disability, age or Vietnam era/disable veteran status in employment or in the application, admission, participation, access and treatment of persons in instructional programs and activities. I certify that the information provided is accurate and correct to the best of my knowledge. I understand that consent is given to Phoenix College to release academic, financial or any other necessary information required as it pertains to this application process. All information is confidential and will only be used to assist in this process. Signature______________________________________Date____________________ REV: 4/12
Applicant in<strong>for</strong>mation:<br />
Name (Last, First, M.I.)<br />
Student ID #___________________________________________________________<br />
Email_________________________________________________________________<br />
Address_______________________________________________________________<br />
City, State & Zip_________________________________________________________<br />
Telephone (best number to reach you)_______________________________________<br />
Check those that apply to you:<br />
I am a first generation college student (You are a first generation college student if both parents or<br />
guardians [parent or guardian if only living with one] did not complete a bachelor’s degree)<br />
Yes____ No____<br />
I am an adult returning to college (21 years or older) Yes____ No____<br />
I am seeking a(n):<br />
____Associate’s Degree (Projected completion date:________)<br />
____Certificate (Projected completion date:________)<br />
____Plan to transfer to ______________________________by__________<br />
Name of institution<br />
(mm/yy)<br />
____Bachelor’s Degree (Projected completion date:________)<br />
____Other (explain):____________________________________________<br />
Major/Academic program of study:_________________________________<br />
Currently enrolled in college? Yes_____ (If yes, complete next section) No____<br />
I am currently attending __________________________________, where I have<br />
accumulated_____credit hours (list total # of credit hours earned after current<br />
semester) and my cumulative GPA is_____. I plan to attend______________________<br />
<strong>for</strong> the ___________________, _______ semester and register <strong>for</strong> __________ credit<br />
spr./sum/fall<br />
yr.<br />
hours.
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