Latino Dollars for Scholars

Latino Dollars for Scholar

foundation of Rhode Island

2008/2009 Scholarship Application

STUDENT INFORMATION

First Name Middle Initial Last Name

Permanent Address

City State Zip Code

Phone Number E-Mail Address

Sex M F Date of Birth (MM/DD/YYYY) Social Security #

Name of Parent or Guardian

SCHOOL INFORMATION

High School Attended

Graduation Date (MM/YYYY)

If you did not complete High School, indicate date & place GED was completed:

Date Place

Post-Secondary School which applicant will attend or is currently attending

4 Year College/University	Voc-Tech
Community College	Other

Name of Institute

Address

City State Zip

Year in post-secondary during coming school year: Undergraduate 1 2 3 4 5

Student will: Live on Campus Live off campus Commute

Student will be enrolled: Half time or more Full time

Anticipated date of graduation from post-secondary program:

Major field of study applicant plans to pursue:

PERSONAL INFORMATION Describe your work experience during the last four years. Indicate the dates of employment in each job and approximate number of hours worked each week. List total amounts earned at each job.

Name of Company	Position	From (date)	To (date)	Hours/Week	Earnings

List school activities in which you have participated during the past 4 years (e.g. student government, music, sports, etc.). List community activities in which you have participated as a volunteer during the past 4 years (e.g. neighborhood assistant, church work, community work, community clubs, community organizations). Indicate special awards and honors.

Activity	No. of years participating	Special Awards, Honors

Personal Statement #1:

Tell us about yourself. What are your aspirations? What is your proudest achievement?

Please e-mail your personal statement to application@ladori.org. This can be a Word document or written in your e-mail message. Please note: Your personal statement is required to complete your application.

Personal Statement #2:

Tell us about your experience as a Latino. What has been your involvement in the Latino Community?

Please e-mail your Latino experience essay to application@ladori.org. This can be a Word document or written in your e-mail message. Please note: Your Latino experience essay is required to complete your application.

Financial Statement: (download pdf version of Finanical Statement)

Please complete and sign the Financial Statement. Please mail the completed Financial Statement to the address below. Please note: Your Financial Statement is required to complete your application.

Latino Dollars for Scholars

P.O. Box 6764

Providence, RI 02940

(401)837-7152

application@ladori.org