StocktonUnifiedSchoolDistrict斯托克顿学区.doc

Counselor:_2008 2009_ High SchoolStockton Unified School DistrictGeneral Scholarship ApplicationAll information MUST be typed. Go to www.stockton.k12.ca.us and save to document file and you will be able to type application.Name: (Last) (First) (Middle)Student ID Number:E-mail Address:Insert a picture of yourself here.Date of Birth:Place of Birth:Home Address:Home Phone:Cell Phone:Race/National Origin:Educational InformationFathers Name: Occupation: Employer:School:Mothers Name: Occupation: Employer:(Weighted)Total G.P.A.:Total number of people living in home including parents:Rank in Class:Number of Dependent brothers & sisters living in home:UC/CSU G.P.A.:Number of Dependent brothers attending college:Number of Dependent sisters attending college:College Major:Does your family contribute to their financial support? (Please explain)1st Choice College:2nd Choice College:I am planning a career as:SAT: _What degree do you plan to obtain? AA BA/BS MA Ph.D.ACT: _Deadline to Counselor: Friday, January 16, 2009Deadline to Student Services on Scholarship Due DateRevised August 2, 2008Name: _ Date: _List your parents memberships in professional or work related organizations:List your parents membership in service and civic organizations:List your parents union affiliations:Religious preference: (optional)Is your parent/or grandparent a member of the Armed Forces? If yes, which branch?Is your parent/or grandparent a veteran?Disabled veteran?Deceased veteran?In your own words, explain why you are applying for a scholarship and state any compelling reasons to justify your need to apply for financial aid. Outline any unusual financial circumstances that would clarify your status and eligibility for a scholarship. (Please only address your financial situation in this area.) Please type your response. Use a separate sheet of paper if necessary.FAMILY FINANCIAL STATUS REQUIRED (One of the two choices below MUST be filled in.)The most recent copy of the Federal Income Tax Return Form 1040, pages 1 & 2 OR a copy of the Passport to Service form MUST BE ATTACHED. (Social Security number will be removed after verification made by counselor.) Annual Gross Income:$_Adjusted Gross Income:$_ OR Annual Family Public Assistance:$_(To obtain a copy of the Passport to Service, if your family support comes from public assistance, contact your eligibility worker at San Joaquin Human Services Agency, 468-1000).Date: _ACTIVITIES RECORDName: _ Grade: _List each activity under the appropriate headings. Mark an “X” in grade column to show year of participation. Indicate any office held.SCHOOL ACTIVITIES 9 10 11 12 COMMUNITIY ACTIVITIES 9 10 11 12 Student GovernmentOrganizationsAthleticsCheerleader, Band, etc.Awards, Honors, Summer Programs/Activities(Travel, Camp, Leadership)OrganizationsChurch ActivitiesEmploymentAwards, Honors, otherAchievementHobbies & InterestsCommunity ServiceCheck ALL that apply to you. Special scholarships are available to students in the following categories:Agri-Business EducationKey Club _ OfficerAmerican Indian descentInteract Club _ OfficerAsian descentPlanning career in physical, biological or African Americanengineering sciencesChinese descentSports Letter in varsity _ SportFamily name of Louie, Fong, Kwong or WongChild of Stockton FirefighterFilipino descentPlanning a teaching career_ Elementary_ SecondaryGreek descentVocation training post high schoolHispanic descentMusic majorMexican/American descentMale applying to UC BerkeleyJapanese American descentPlanning to attend Delta CollegeItalian Catholic descentBilingual (2 years minimum ELD program)Nordiska Member, Nord LodgeCalifornia School Employees (Parent)Portuguese descentGATE identified studentCivil EngineeringInsurance field (Parent) Head Start (enrolled prior to entering school)Military (parent/grandparent Are you a Raider fan?Active/retired)Legal Secretary or Secretarial fieldOtherCOLLEGE PLANSMajor: _Probable Vocation: _College Choice: _Letters of Recommendations Requested of:1) _2) _3) _Stockton Unified School DistrictRecommendation Letter FormTo the Applicant:Please fill in the personal information below and then give this form to the person submitting your recommendation letter. PLEASE TYPE OR PRINT NEATLY.Name of Applicant: _ Last NameFirst NameMiddle NameApplicants Address: _ Street Address City State ZipSchool Now Attending: _ School Phone: _ To the School Staff or Community Person Writing this Recommendation: Please fill this form out and return to Name, _ High School Scholarship Chair, _, Stockton, CA 952-, at 933 XXXX. This report is based on: _ Personal contact with student _ Records _ Other _How long have you know the student? _In what capacity? _How often do you meet with the student? _How well do you know the student? _Name of person completing this report: _Title: _Work Phone ( ) _ ext. _ Email: _1. Checklist The checklist is provided for those who feel comfortable using such a rating system and know the student well enough to give us an accurate assessment of him/her in comparison to other college- bound students you know.No Basis for JudgmentBelowAverageAverageGood (Above average)Very Good(well above)Excellent(top 10%)One of the Top Few Ive knownInitiative/motivationIntellectual curiosityCreativitySelf confidenceLeadership/influenceIntegrityConcern for othersWarmth of personalityEmotional maturityIf you wish to give reasons for any of your ratings, please do so on back of form.Respect accorded by peers2. Academic/IntellectualIn what ways might you distinguish this students academic performance from that of other qualified students? Either through personal experience or in talking with others, how would you characterize this students level of intellectual curiosity and approach to learning?3. Personal/