ALE Scholarship Application

Name*

First Last

Lancer ID #*

Date of Birth

Current Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone*

Email*

Enter Email Confirm Email

Have you applied for Financial Aid for the current academic year?

Yes
No

Major

Cumulative GPA at PCC*

Spring Units at PCC

Total Cumulative Units Completed at PCC*

Educational Goal at PCC*

Expected Graduation Date

If applicable

Expected Transfer Date

If applicable

Extracurricular Activities

Begin with the most recent or significant. Use the + button to add additional activities.

Organization	Description of Activity	Supervisor	From Month/Year to Month/Year	Hours/Year

Volunteer Activities

Begin with the most recent or significant. Use the + button to add additional activities.

Organization	Description of Activity	Supervisor	From Month/Year to Month/Year	Hours/Year

Employment Experience

Begin with the most recent or significant. Use the + button to add additional work experience.

Employer	Position	Supervisor	From Month/Year to Month/Year	Hours/Week

Statement of Purpose

Write a 2-page, double-spaced essay addressing the following points:

Describe your academic plans and career goals.
Describe your interactions with the Latino/a/x community and how through your interactions you have an understanding of the Latino culture.
Given your personal background, explain how achieving your career goals will positively affect the Latino/a/x community.

Upload your statement of purpose here*

Filetypes allowed are doc, docx, and PDF

Personal Background Information

Who in your immediate family (only parents or siblings) has obtained the highest level of education?*

Father
Mother
Sibling
Unknown

Given your answer to the question above, what is the highest level of education that family member (parent or sibling) has obtained?*

How many people live in your family household?*

Are you a Dependent or Independent student?*

Under federal regulations, you are considered a dependent student if you are under 24 years of age (unless you are a graduate student; are married or have dependents other than a spouse; are an orphan or ward of the court; or are a veteran of the U.S. armed services).

Dependent
Independent

Dependent Students Only

What was your family’s household total income for the previous year?*

Less than $24,000
$24,000-$72,000
$72,000 or more

Independent Students Only

What is your family’s household income (combined with your spouse’s income if married) for the previous year?*

Financial Need

Explain any unusual circumstances that demonstrate a significant financial need.*

Nominator's Information

Nominator's Name*

Nominator's Email or Phone number*

Certification*

I agree to the following:

In signing this application, I declare that all the information provided is true and complete to the best of my knowledge. I understand that I may be asked by the committee to provide documentation to corroborate the above information in order to receive scholarship payments. I understand that if any information in this application is found to be untrue it may result in termination of the scholarship. I also understand that ALE reserves the right to review the condition and procedures of this scholarship program and to make changes at any time including the termination of the program. I understand that ALE has permission to access my academic records.

Name

This field is for validation purposes and should be left unchanged.