Board of Directors President
Chaffey Joint Union High School District
Immediate Past President
James Touchstone Jones & Mayer
Vice President Loren Sanchez Secretary Ken Galasso Sierra Realty Treasurer Vacant Mark Barragan Estrada Strategies Jeanne Batista JMBatistaSolutions Members Virginia Aguilar-Riley Guillermo Canjura Guillermo Canjura, DDS Mary Caporale Edward Jones Glenn Duncan City of Chino Richard Egger Best Best & Krieger, LLP Aref Fakhoury ARMGHRD Group, Inc. Otis Greer
County of San Bernardino Sue Oxarart
Ontario Convention & Visitors Bureau Sandra Rose Henry Shannon Chaffey College Chris Taylor HMC Architects
Chaffey College Support Staff
Lisa C. Nashua, MSLM Executive Director, Foundation and Governmental Relations Marie Baston
Foundation Coordinator Lissa Napoli
Administrative Assistant II Sharon Awad
Scholarship Program Assistant
Dear Chaffey College Student:
Thank you for your interest in applying for a Chaffey College Foundation Scholarship.
We are proud to provide scholarships to qualifying and deserving students. Through
the generosity of local businesses, professional associations, and individuals, the
Chaffey College Foundation is able to offer scholarships to students pursuing their
Please read the following valuable information to make sure you are fully aware of the
requirements for these scholarship opportunities. It is important that you follow all
directions and fully complete the application packet.
You must be a registered and current Chaffey College student. All Chaffey College
Foundation Scholarships will be awarded in the
Recipients receive a scholarship account card that can be used to purchase books and
supplies at the college bookstore, or at the Cashier’s Office to pay for any fees or
charges related to enrollment. Any scholarship recipient that is dismissed from, or
drops out of Chaffey College will forfeit their scholarship.
Applications will be accepted during the fall and spring semesters of each academic
year. The Chaffey College Foundation Scholarship Committee reviews applications
twice a year for awarding. Scholarship applications for the
scholarship round of the 2015-2016 academic year will only be accepted between
November 1, 2015-January 20, 2016.
Applications are being accepted in the
Foundation Office (MOD-1 Rancho Campus), the Fontana Campus Bookstore
(FNAC-129), and the Chino Campus Bookstore (CHMB-149).
You must submit a new application for each semester (fall or spring) in order to
be considered for scholarships for that semester.
Your application will be evaluated according to the following general eligibility
Demonstrated Financial Need
Minimum Cumulative GPA of 2.5 and/or Evidence of Significant Improvement
in Academic Performance.
Community and/or College Involvement
Transcripts: IF this is your first semester here at Chaffey College you will need
to submit an unofficial transcript from the previous school you attended. You
can visit your former school to obtain your transcripts or go to
www.parchment.com, to set up an account and receive your transcripts in the
mail. Fees may apply.
Please include as much information as you feel comfortable sharing. Remember that this is your ONLY
opportunity to share with the scholarship committee WHY you need this scholarship and since they will not
have the opportunity to meet with you at this time make sure to tell them about yourself in the essay portion of
this application. Please feel free to add additional word documents if necessary.
Lisa C. Nashua, M.S.L.M.
Online application available at:
For Office Use Only
Date & Time Received
Chaffey College Foundation Scholarship Application
This scholarship is open to all Chaffey College students regardless of citizenship or residency status.
Student ID Number: Gender: Male Female
New Student Continuing Student Have you received a Foundation Scholarship in the past? Full Legal Name: First Middle Initial _____ Last Date of Birth (mm/dd/yy): _____ _____ _____ Did either of your parents ever attend college? Yes No
Did either of your parents or any other member of your immediate family ever attend Chaffey College? Yes No
(E-‐mail confirmations will be sent out regarding this scholarship application as well as information of other available scholarships.)
Number & Street _______________________________________________________________ Apt. #
City ___________________________ State _____ Zip Code __________ Mobile Phone (_____) ______-‐___________
Home Phone Number (_____) _____-‐_____________ Alternative Phone Number (_____) ______-‐___________
Total units earned to date: __________ Transferable units earned: __________ Cumulative GPA: Current enrollment status: Part-‐time _____Full-‐time_____ Less Than Half _____Transferring: Fall _____ Spring _____ Summer_____ (Minimum 6 units) (Minimum 12 units)
Declared or Expected Major:
(According to your education plan)
*Have you taken any the following courses as of today?
1. CISPROG 1: Intro to Computer Programming Yes______ No______ 2. CISPROG 3: Fundamentals of Visual Basic Programming Yes______ No______
3. CISPROG 403: Advanced Basic Programming Yes______ No______ 4. CIS 431: Project Management for Information Technology Yes______ No______
*If you are a nursing major, are you in the actual nursing program as of today? Yes______ No______
Work experience (list last four jobs only)
WORK EXPERIENCE/ EXTRA CURRICULAR ACTIVITIES
Online application available at:
Are you, or have you ever been a foster youth? Yes_____ No _____ If yes, are you able to provide legal documentation confirming this information? Yes_____ No _____ Have you completed the “Free Application for Federal Student Aid” (FAFSA) form? Yes_____ No _____ If yes, what is the status: _________________________________________________________
Have you ever received a scholarship as a Chaffey College student? Yes _____ No _____ If yes, please list which scholarship(s): _______________________________________________
Are you a veteran of the U.S. armed services? Yes_____ No _____ If yes, are you receiving GI benefits? Yes ____ _ No _____ Are you a registered DPS Student? Yes_____ No _____
Are you a CARE Student? Yes_____ No_____
Are you an EOPS student? Yes_____ No_____
Are you part of the CalWORKs program offered through Chaffey College? Yes_____ No_____
For SECTIONS 1 AND 2: Do NOT fill out both sections, choose one or the other
SECTION 1. INDEPENDENT APPLICANT: (This section applies to you if you were born before January 1, 1990)
Are you currently receiving Government Assistance? If Yes, (check all that apply below) Yes No CalWORKs , CalFresh, or Medical
Are you receiving SSI (Supplemental Security Income)? Yes No Are you receiving GA (General Assistance)? Yes No Economic Status: is your household annual income less than $12,525 (for a single person); $16,875 (for a couple adding $4,350.00 per dependant child)? Yes No Are you a Displaced Homemaker?An individual who has worked primarily without receiving compensation to care for a home and family, and for that reason has diminished marketable skills. Yes No Please estimate your TOTAL annual gross household income: $
SECTION 2. DEPENDENT APPLICANT: (This section applies to you 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/ward of the court, or are a veteran of the U.S. armed services)
Parent(s)’/Guardian(s)’ Marital Status: Single Married Separated Divorced Widowed Mother’s/Guardian’s occupation: _______________________ Father’s/Guardian’s occupation: ______________________ Parents/Guardians TOTAL combined annual gross household income: $__________________________
Do your parent(s)/guardian(s) contribute to your educational expenses? Yes No ___ Do you live with your parent(s)/guardian(s) during the academic year? Yes No___
Number of people your parent(s)/guardian(s) can claim as dependents on their tax return (include yourself): How many dependents are currently in college (include yourself)? _____
Are either parent/guardian a Veteran? __________
Online application available at:
Certification and Authorization: Applicant must read and sign below to be eligible.
“All of the information on this application is true and complete to the best of my knowledge. I certify that I meet all eligibility requirements as specified in this application. I understand that I may or may not receive a scholarship and that filling out this application does not guarantee that I will be selected as a recipient of a Chaffey College Foundation scholarship. I understand that all application materials become the property of the Chaffey College Foundation, cannot be returned, and will be treated as confidential. Any knowingly false statements on this application may disqualify me from consideration for a scholarship. I hereby authorize the Chaffey College Foundation to utilize information about my application, thank you letter, and my likeness for public relations purposes, publicity, or other scholarship opportunities.”