The GoizueTa FoundaTion 2015-2016 ScholarShip applicaTion

The Goizueta Foundation 2015-2016
Scholarship Application
Application and All Supporting
Documents Deadline: April 1, 2015
The Goizueta Foundation Scholarship
In order to be considered for this scholarship, all three parts of the application must be completed and submitted to the Financial Aid Office by April 1, 2015 and meet the following requirements:
• Be accepted for admission at Georgia College for Fall of 2015
• Have a complete file with the Financial Aid Office- which includes completing the 2015-2016Free
Application for Federal Student Aid (FAFSA) www.fafsa.ed.gov and submitting any required documentation
(Allow 2-4 weeks for processing time by the U.S. Department of Education)
• Have a 3.0 or higher overall grade point average
• Have financial need as determined by the Georgia College Office of Financial Aid beyond the assistance of other scholarships received.
• Have immediate family/ legal guardian currently residing in the United States
• Preference will be given to students of Hispanic/Latino Origin
• Mail all documents to: Office of Financial Aid, Attention: Scholarship Advisor
Campus Box 030, Milledgeville, GA 31061
Part I: Applicant Information
Name:____________________________________________ GC Student ID #: _____-____-______
First
Last
Address:________________________________________________________________________________
P.O. Box/Street City
State
Zip
Home Phone: (____)____-________Cell Phone: (____) ____ -________ Email: _____________________
DOB (MM/DD/YYYY: ___/____/_______
High School:___________________________________ ✔ Female
Gender: ☐
☐Male Graduation Date:___/___/_____
Expected Major
Languages: Check those that apply
*Poor *Good *Fluent or Native
at Georgia College:______________________ Spanish:
English:
*Poor *Good *Fluent or Native
Hispanic Heritage; please specify
Other:__________ *Poor *Good *Fluent or Native
country of ancestry:______________________ Other:__________ *Poor *Good *Fluent or Native
Parent/ Guardian Information
Mother/Guardian’s Name:______________________________________ Phone: (____) ____-______
First
Last
Address: _______________________________________________________________________________
P.O. Box/Street
City
State
Zip
Father/Guardian’s Name:_______________________________________ Phone: (____) ____-______
First
Last
Address:_______________________________________________________________________________
P.O. Box/Street
City
State
Zip
Part II: Resume
Attach a resume that includes the following: • Your most significant EXTRA CURRICULAR activities
• Your most significant COMMUNITY SERVICE activities
• Awards and special recognition
By signing below, I certify that the information provided on this form is accurate and complete to the
best of my knowledge. I further understand that any false statement subjects me to forfeiture of my
scholarship.
_________________________________ _________
Applicant’s Signature
Date
_________________________________ ______
Parent/Guardian’s Signature (if under 18)
Date
Part III: Essay
Essay Instructions:
This essay will be used as part of the consideration process for the Goizueta Foundation Scholarship
at Georgia College. Your essay should be approximately one page in length and no more than 500
words. If attaching your essay, please be sure to include your full name on the essay so that it can be
matched to your application if the two documents become separated.
Topic: Describe how your Hispanic heritage has influenced your academic career and how you plan
to increase the visibility of Hispanic/ Latino culture in Georgia.
Part IV: Recommendation/Evaluation Form
Student Name: _____________________________________________________________________
The student named above is applying for The Goizueta Foundation Scholarship at Georgia College.
Your recommendation is needed as a part of the application process. Please return this form to
the applicant in a sealed envelope with your signature across the
so the student may submit it as part of the application packet.
Please Note: In addition to completing the form, also include a personal
letter of recommendation.
Name of Evaluator: ________________________________
Title:______________________________
Place of Employment: ____________________________________________________________________
Mailing Address:_________________________________________________________________________
(P.O. Box/Street)
City
State
Zip
Phone Number: (____) _______________ Alternate Phone Number: (_____) ___________________
Please answer the following questions. Use a separate sheet if necessary.
1. How well do you know the applicant? What is the nature of your relationship?
2.
5 = Exceptional
| 4 = Above Average | 3 = Average | 2 = Below Average | 1 = Poor
5
4
3
2
1
Demonstrates a well-rounded attitude and positive outlook on academics
Concern for others
Initiates leadership activities
Integrity
Intellectual ability
Respect for and treatment of others
Responsibility
Self-motivation
Understands and expresses thoughts and feelings clearly
Emotional stability
Please check one:
*Highly recommend this candidate | *Recommend this candidate | *Not recommend this candidate
_____________________________________________________
Evaluator’s Signature
____________________
Date
The Goizueta Foundation Scholarship
application Checklist:
☐ Application
☐ Resume
☐ Essay
☐ Evaluation Form
☐ Recommendation Letter
☐ FAFSA
☐ Other documents if requested by the GC Financial Aid Office
Mail all documents to
Georgia College
Office of Financial Aid
Attention: Scholarship Advisor
Campus Box 030
Milledgeville, GA 31061
For more information, please contact:
Javier Francisco
Associate Director of Enrollment Management
Georgia College
Office of Admissions
Campus Box 23
Milledgeville, GA 31061
(478) 445-1991
javier.francisco@gcsu.edu