Eva Kastan Grove Scholarship - Hunter College

DIVISION OF STUDENT AFFAIRS

THE EVA KASTAN GROVE SCHOLARSHIP APPLICATION FOR UNDOCUMENTED, IMMIGRANT OR CHILDREN OF IMMIGRANTS

ELIGIBILITY / DEADLINE / CHECKLIST/SUBMISSION INSTRUCTIONS

Eligibility Requirements:          

Undocumented or DACA (Deferred Action for Childhood Arrivals) or TPS (Temporary Protective Status), or Immigrants (firsts generation in U.S.), or Children of Immigrants (second generation in U.S.) and Low income and/or first generation college student and Part of an underrepresented voice in their field Must be enrolled or already accepted at Hunter College - CUNY for Spring 2016 Must be registered or registering in first matriculated Bachelor Degree Must be eligible for in-state tuition Have a college grade point average of at least 3.0 or Have a high school grade point average of at least 2.5 Must plan to pursue a career in the United States Have a history of, or future commitment to public service

 

Second Bachelor Degree and Master students are ineligible International Students (persons attending Hunter on a current student visa) are ineligible

Application Deadline and Materials: Full-time and Part-time Scholarships are available. You must submit this application form along with the following required documents to complete your application by the deadline: December 30, 2015 at 5:00 pm  Most recent undergraduate student transcript or completed high school transcript  Personal Statement (Tell us about yourself, approximately two typed pages)  Essay (Please describe any cultural, economic, physical or educational challenges that you or your immediate family have overcome)(approximately one typed page)  Attached recommendation form and supplemental letter of recommendation from someone that has served in one of these roles: teacher, counselor, mentor, coach, community leader, or program coordinator.  DACA or TPS approval letter or  Other documentation demonstrating continuing presence in the U.S.

Application Checklist:   

Make sure there are no grammatical errors or type-os on the application. Be professional. Please do not submit a messy application. Do not use white-out. If necessary, ask for another application. Please make sure all information provided is clear and accurate. Make sure your recommenders understand that in addition to executing the recommender’s form, they must also write and submit a letter of recommendation on your behalf.

Submission Instructions: Please mail or drop off application and materials to: Mr. Chris Aviles, Student Services Specialist Hunter College, Division of Student Affairs, room 1132-East Building, (or 1103E) 695 Park Avenue, New York NY 10065 If you have any questions or concerns regarding this application, please contact Chris Aviles at [email protected] or 212-396-6846.

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Inquiry Form 1. Student’s Name: __________________________________________

Sex: M _____ F______

2. Empl ID Number: __________________________________________________________________ 3. Date of Birth: _______________________________________________________________________ 4. Permanent Address: _____________________________________________________________________________________ Street

Apartment #

_____________________________________________________________________________________ City

State

Country

Zip Code

_____________________________________________________________________________________ Daytime Telephone Number

Evening Telephone Number

_____________________________________________________________________________________ Email Address

5. Current Mailing Address (if different from above): _____________________________________________________________________________________ Street

Apartment #

_____________________________________________________________________________________ City

State

Country

Zip Code

_____________________________________________________________________________________ Daytime Telephone Number

Evening Telephone Number

6. Academic Information: Undergraduate Major or Intended Major: Current Grade Point Average: _____________________________________________________________ College credits completed to date: __________________________________________________________ List College Honors/Awards: _____________________________________________________________________________________

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7. Country of Origin (birthplace) Are you a citizen of the United States?

□ Yes

□ No

Do you have Deferred Action for Childhood Arrivals (DACA)?

□ Yes

□ No

Do you have Temporary Protective Status?

□ Yes

□ No

Do you have any other type of immigration status that allows you entry or residence in the U.S.?

□ Yes

□ No

If so, please indicate ____________________________________________________________________ 8. Please indicate what language(s) is/are spoken in your household: 9. Please list any college extracurricular activities in which you participated and any officer or leadership positions held:

10. Please list any talents, awards or honors you have received in college: academics, sports, musical ability, etc.

11. Please list any special interests, talents or hobbies you may have:

12. Please list any civic/religious/charitable /public service activities in which you are involved and any officer and leadership positions held outside of college:

13. Employment/Volunteer History: List all past employment that you have held since high school graduation and specify whether it is full-time or part-time. Employer and Location

Nature of Position

Reason for Leaving

Dates

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14. Student Financial Information: Are you employed full time? __________________________________ Are you employed part-time? _________________________________

hours/wk__________________ hours/wk__________________

Approximately how much of your earnings are used to support yourself? ____________________________ Employer Name & Location: ___________________________________ __________________________ Your position: _________________________________________________________________________ 15. Family Background Information: Father’s Name:

Occupation:

Address: Telephone Number: ___________________________ Cell Phone Number: ________________________ Level of Education: Mother’s Name:

Occupation:

Address: Telephone Number: ____________________________ Cell Phone Number: _______________________ Level of Education: Total Parent Income (Documentation will be requested): ________________________________________ Annual household/Family income information (Documentation will be requested): ____________________ Total number of family members living in household: ___________________________________________ List all family members living in household and your relationship to that member: (Include self) Name

Relationship to self

Name

Relationship to self

Applicant Signature: I swear or affirm under the penalty of false swearing that all information provided in or with this application is true, correct, and complete to the best of my knowledge. I understand that any false statements, misrepresentation, or omissions of face in or with this application are grounds for denial, suspension, or revocation of participation in The Eva Kastan Grove. Print Name

Signature

Date

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Program Rules 1.

Eve Katan Grove Scholars are required to write a “Thank You Letter” to the Eva Kastan Grove family.

2.

Eva Kastan Grove Scholars are required to maintain a 3.0 GPA or better throughout their college academic career. Failure to meet this requirement may result in expulsion from the program.

3.

Eva Kastan Grove Scholars must be enrolled at the college full-time (minimum of 12 credits) and attend all semesters consecutively. Gap semesters are generally not allowed. Exceptions can be made for both part-time status and gap semesters in extenuating circumstances. However, even in extenuating circumstances, prior approval must be received.

4.

Eva Kastan Grove Scholars for undocumented students must retain their undocumented, DACA or TPS status in order to remain in the program. It is the scholar’s responsibility to inform the program coordinator of any changes to their status. At which time, they may become ineligible to continue in the program. If it is later revealed that a scholar has obtain some type of citizenship and failed to informed the program, their award may be rescinded for the period in question and the scholar will be financial liability for courses taken during this time.

5.

Eva Kastan Grove Scholars are expected to attend every orientation, workshop and event associated to this program. Absences are not tolerated and will only be excused for family or medical emergencies. Proof of the emergency has to be supported by official written documentation. Even excessive absences for excused family or medical reasons may result in expulsion from the program.

6.

Cases of Eva Kastan Grove Scholars found guilty of plagiarism, academic integrity or conduct disorder may result in their expulsion from the program. This will be managed on a case by case basis.

7.

The Eva Kastan Grove Scholars are responsible for timely response and action to all email, phone and text correspondences from the program and Hunter College Administration.

8.

Hunter College reserves the right to make adjustments and changes to the overall program and rules that govern The Eva Kastan Grove Scholarship. Scholars will be notified of such changes with ample time to meet the terms and remain in good standing.

My signature below attests that I have read the Eva Kastan Grove Scholarship Program rules and if selected to participate in the program, agree to abide by them during my academic career as an Eva Kastan Grove Scholar. I understand that failure to comply with the program rules may result in my removal of the program and the loss of the financial award associated to it.

_____________________________________________________________________________________ Print Name

Signature

Date

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FERPA Waiver and Permission: WHEREAS, the Family Educational Rights and Privacy Act (“FERPA”) (20 U.S.C. §1232g; 34 CFR Part 99) is a Federal law that protects the privacy of student education records. FERPA applies to all schools that receive funds under an applicable program of the U.S. Department of Education. WHEREAS, FERPA gives parents certain rights with respect to their children's education records, these rights transfer to the “eligible students” when he or she reaches the age of 18 or attends a school beyond the high school level. WHEREAS, schools generally must have written permission from the parent or “eligible student” to release any information from a student's education record to any outside individuals, entities and/or institutions. NOW THEREFORE, by signing this FERPA Waiver and Permission, I waive my rights under FERPA and give permission, in our sole discretion, to disseminate my personal information as follows: 1.

I agree to give full expressed acknowledgment, waiver, and permission allowing CUNY and The Eva Kastan Grove Scholarship Coordinator at Hunter College to review the information that I submit as part of being an applicant and/or participant in The Eva Kastan Grove Scholarship.

2.

I agree that the submitted information as an applicant and/or participant in the Program will also include all of my academic records (and other relevant information) from now until completion of the bachelor degree.

3.

All student information may be shared regularly with CUNY and personnel that are or can be potential funders for this Program.

4.

Best efforts will be taken to keep my student information (such as, but not limited to, my student name, citizenship status and Empl ID number) confidential.

5.

My signature below indicates that I have read and fully understand the contents of this FERPA Waiver and Permission.

6.

I also affirm that my signature is fully voluntary and agree to all the terms set forth in this waiver and permission.

I authorize Mr. Chris Aviles or current Eva Kastan Grove Scholarship Program Coordinator to obtain from the Admissions Office, the Financial Aid Office, and the Registrar’s Office any academic records/data pertinent to my participation in this program. Print Applicant Name __________________________________

Date____________________

Signature of Applicant __________________________________

Date____________________

Parent’s signature (if under 18) ___________________________

Date ____________________

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RECOMMENDATION FORM Division of Student Affairs Eva Kastan Grove Scholarship Please mail or hand-deliver to: Chris Aviles Hunter College Division of Student Affairs, room 1132E (or 1103E) 695 Park Avenue, New York NY 10065 Please fill in your name below and forward this form to the person that will be completing your recommendation. Recommendation form and attached letters should be sent directly to the above address or they can be hand-delivered if the individual has signed his/her name across the back of the sealed envelope. Type or Print Clearly Name of Applicant _____________________________________________________________________________ Last

First

Middle Initial

Name of Recommender _________________________________________________________________________ To Recommender: Please complete form and attached a typed letter of recommendation on your letterhead. How long and in what capacity have you known the applicant? ___Years and/or ____months In what capacity? ______________________________________________________________________________ Please evaluate the applicant in each of the following categories below by placing an “X” in the appropriate box. How does this applicant compare to others you have worked with in a similar capacity. Category Academic Promise Motivation Teaching Potential Research Potential Speaking Skills Writing Skills Mathematical Ability Maturity Emotional Stability Ability to Accept Constructive Criticism Ability to Work with Others

Poor

Average

Good

Outstanding

Unable to Judge

Summary Evaluation Please attach a typed letter of recommendation evaluating the applicant’s strengths and areas for further development. _______ I do not recommend the application for admission to The Eva Kastan Grove Scholarship. _______ I believe that the applicant qualifications are marginal although the applicant has potential. _______ I recommend this applicant for admission. _______ I strongly recommend this applicant for admission. _____________________________________________________________________________________________ Evaluator’s Signature

Date

_____________________________________________________________________________________________ Evaluator’s Name (Print)

Position

Phone Number

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