2015-16 Winter/Spring Term Scholarship Application
GETTING STARTED:This application is to be used for the purpose of applying for “tuition-only” scholarships to be used only at Columbia Gorge Community College (CGCC).
Award preference may be given to local residents of Oregon and Washington.
All scholarship recipients must complete the college placement assessment and meet with an academic adviser prior to registering for classes if they have not already done so.
Scholarship recipients may be asked to provide two hours of volunteer service per term to benefit the foundation and/or college. It is also requested that scholarship recipients submit a thank-you card to CGCC Foundation on condition of receiving the scholarship.
Submit all information on 8 ½ x 11” paper only. Please staple all application materials together. When submitted, this application becomes the property of CGCC.
Additional conditions may apply.
Award recipients will be sent a notification letter by December 11, 2015.
THE FOLLOWING CRITERIA WILL BE USED TO DETERMINE ELIGIBILITY: Application: neatness and completeness
Academics: skills showing good aptitude for field of study Financial need: family size, resources available, etc. Attitude: general worthiness and desire
Activities: past/present employment, community service, etc.
Satisfactory academic progress per CGCC standards each term of enrollment Six credit minimum enrollment each term of attendance
THESE ITEMS MUST BE INCLUDED IN YOUR APPLICATION PACKET:
Application Form. Remember to sign and date!
One (1) page essay (maximum) about yourself. 10-12 pt. font, single spaced, typed. Consider including youreducational/career goals, community activities, and financial conditions or life circumstances that contribute to your need for a scholarship.
Two letters of recommendation (only) addressed to Columbia Gorge Community College Foundation. Letters must include signatures, contact information and disclose the relationship, such as employer, school counselor or teacher.
Attach proof that you have calculated your Estimated Family Contribution. Acceptable proof is the confirmation page from your FAFSA for 2015-16. Or, you may attach the EFC calculator estimate from CollegeBoard.org. Be aware that receiving a scholarship may affect your Federal Financial Aid award.
Attach high-school transcript if you have graduated from high school within the last two years (unofficial copies accepted).
Attach ALL academic transcripts from all colleges you have attended or are currently attending, including CGCC. If you donot have transcripts, please note the reason. (Unofficial copies are acceptable.)
MAINTAINING ELIGIBILITY: All students who are awarded this scholarship must maintain satisfactory academic progress as required by CGCC’s Satisfactory Academic Progress (SAP) Policy. See www.cgcc.edu/financialaid/awardinformation.cfm.
INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED.
DELIVER YOUR COMPLETED APPLICATION PACKET TO STUDENT SERVICES NO LATER THAN:
NOON, THURSDAY, November 19, 2015.
The Dalles Campus Hood River-Indian Creek Campus 400 East Scenic Drive 1730 College Way
2015-16 Winter/Spring Term Scholarship Application
Instructions: Please type or use a black pen. Answer all questions completely.
Step I – Personal and Educational Information
Name: Student No.
Address
City State Zip
Phone: Email
List all members of your household (including siblings residing there) and their relationship to you:
List your community interests, activities, and achievements:
Are you currently employed? Yes No If so, where? Describe your past work experiences (part-time/full-time, volunteer)
I am a: New Student Returning Student
I am applying for: Full-time (12 credits) Part-Time ( _____ credits) Please check the appropriate box for other financial aid applications completed:
Federal Financial Aid
Private Scholarships (describe) Other (describe)
Are you in default on any student loans? Yes No If yes, please explain
Are you eligible for any benefits from the Veterans Administration? Yes No Are you eligible for any funds from Bureau of Indian Education? Yes No List other funds
The Dalles Campus Hood River-Indian Creek Campus 400 East Scenic Drive 1730 College Way
Step II – Education and Goals
Name Dates attended Graduate (Y/N) Credits
High school (or GED)
Previous College
Previous College
Other
Primary field of study at CGCC
Long-term degree or certificate goal
Expected date of graduation at CGCC
Step III – Financial Information of Your Household
MONTHLY EXPENSES: Student (A) Spouse (B) Parent / Other (C)
Rent / Mortgage (Circle One) Electricity/Water/Phone Car Insurance
Car Payment
Car Maintenance (gas/repair) Food
Childcare Child Support
Medical / Dental Expenses Clothing
Personal Expenses Loan payments Other (Itemize)
TOTAL $ + $ + $
ANNUAL STUDENT TOTAL: A $ x 12 = Annual Student Expenses $
ANNUAL HOUSEHOLD TOTAL: A + B + C $ x 12 = Annual Household Expenses $ COLLEGE EXPENSES: (D) Estimated CGCC tuition and fees for 2015-16 academic year $
(E) Estimated books and supplies for 2015-16 academic year $
(F) Estimated college expense total for 2015-16 academic year (D + E = F) $
Step III – Financial Information of Your Household (cont.)
MONTHLY INCOME: Student (A) Spouse (B) Parent / Other (C)
Job (net earnings)
Savings Social Security Veterans Benefits Child Support Investment Income Other (Itemize) TOTAL $ + $ + $ ANNUAL STUDENT TOTAL: A $ x 12 = Annual Student Income $
ANNUAL HOUSEHOLD TOTAL: A + B + C $ x 12 = Annual Household Income $
ADDITIONAL COMMENTS REGARDING FINANCIAL SITUATION
Step IV – Estimated Family Contribution Information
FAFSA Applicants – Please attach evidence of your Federal Financial Aid application including your Estimated Family Contribution.
EFC
Non-FAFSA Applicants – Please attach evidence of your financial need by estimating your Estimated Family Contribution using the EFC calculator. You may access the EFC calculator from CollegeBoard.org:
I hereby authorize Columbia Gorge Community College and my instructors to release all attendance, grades, and other records requested by the Columbia Gorge Community College Foundation for the purpose of scholarship consideration. This release is effective now and in the future, until such time as this release is rescinded in writing to the attention of Lori Ufford, Chief Academic and Student Affairs Officer at Columbia Gorge Community College. I certify that all of the information and statements contained within this packet are complete, accurate, and true. Falsifying information may result in loss of scholarship.
SIGNATURE
DATE
CGCC Policy Statement: Student scholarship applicants agree to the conditions of the Code of Student Conduct (http://www.cgcc.edu/about/30a-student-rights-responsibilities-and-conduct). CGCC employees agree to abide by all applicable employee policies (http://www.cgcc.edu/about/70b-employee-code-(http://www.cgcc.edu/about/30a-student-rights-responsibilities-and-conduct).
It is the policy of Columbia Gorge Community College and its Board of Education that there will be no unlawful discrimination or harassment on the grounds of race, color, sex, marital status, national origin, religion, age, disability, veteran status, sexual orientation, and any other status protected by applicable local, state, or federal law in any educational programs, activities, or employment. Persons having questions about equal opportunity and nondiscrimination should contact the following:
Mailing Address for All Equal Opportunity Contacts Columbia Gorge Community College
ATTN: (fill in appropriate name from below) 400 East Scenic Drive
The Dalles, OR 97058
Employment:
Robb Van Cleave, Chief Operating Officer Office: Rm. 2.422 Phone: 541-506-6151
Civil Rights; Educational and Student Programs, Activities, and Services; Title II Coordinator: Lori Ufford, Chief Academic and Student Affairs Officer
Office: Rm. 2.191 Phone: 541-506-6031
Title IX Coordinator:
Michael Taphouse, Director of Advising and Career Services
Office: Rm. 3.224 Phone: 541-506-6026
Section 504 Coordinator:
Shayna Dahl, Disability Resources Advisor
