TEST FORM
Pajaro Valley Unified School District
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Local Scholarship Application 2012
Over $500,000 in scholarships and aid were made available to graduating seniors last year throughout our district. This money comes from people in the community and from the staff of PVUSD. These donors have specific requirements such as: the type of college or university you will be attending, your field of study, or other special criteria. If you are selected for a scholarship and you change from a four-year to a two-year college or change your field of study, you may not receive the scholarship. When filling out the application, be as specific as possible. There are scholarships available to students of all academic standings and many are based on need or community service.
Before you start:
You must complete this application in one sitting. Your work will NOT BE SAVED. You will have to start this application from the beginning if you log out. Make sure to have all required information prior to starting online application. PAPER COPIES OF APPLICATION ARE AVAILABLE IN THE GUIDANCE DEPARTMENT. It is also recommended that you have a copy of your brag sheet / senior profile sheet when filling this out.
Application Deadline is March 30, 2012 by 3:30 pm
To be considered for these scholarships you must provide the following:
Scholarship Application
Upload a current transcript
Upload page 1 of your student aid report on FAFSA (only for need based scholarships)
Upload a copy of your parents' 2011 income tax forms (only for need based scholarships)
Upload a recent photograph
Upload a ONE PAGE statement regarding your academic objectives, future goals, and aspirations.
Parent and student electronic signature
Submit electronic application by March 30, 2012 by 3:30 pm
I understand that I need to upload documents to this application. Therefore, I must have these documents available in PDF or Microsoft Word before starting this application.
*
Yes - I understand the above statement
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Applicant Information
What high school do you attend?
*
Please Select
Aptos High School
Pajaro High School
Watsonville High School
Academy / Den
*
Student ID Number
*
E-mail
*
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Cell Phone Number
-
Area Code
Phone Number
Home Phone Number
*
-
Area Code
Phone Number
Your Gender
Female
Male
Birth Date
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Ethnicity (check all that apply)
*
Native Indian/Alaska Native
Filipino
Vietnamese
Black/African American
Japanese
Hispanic/Latino
Puerto Rican
Portuguese
Native Hawaiian/Pacific Islander
Slavic
Danish
Italian
Swiss
Other
If other, please list here
Upload your picture
*
Upload current transcript
*
Enter your GPA as shown on your transcript.
*
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Special Criteria Established by Donors
To be considered for these scholarships, please check the appropriate box.
I am Catholic:
*
Please Select
Yes
No
I am a migrant student:
*
Please Select
Yes
No
I live on a farm or my family income is from farming
*
Please Select
Yes
No
I attended Freedom Elementary or Hall District
*
Please Select
Yes
No
I attended Valencia Elementary School
*
Please Select
Yes
No
I attended Pajaro Middle School
*
Please Select
Yes
No
I will be the first in my family to attend college
*
Please Select
Yes
No
My family has lived in the Pajaro Valley for this many years
*
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What will you study in college (Major)?
*
List major or field of study
1
2
3
What are your career or professional goals?
*
List career or professional goals
1
2
3
After high school I ...
*
Please Select
Plan to apply directly to a 4 year university
Plan to attend Cabrillo or other community college & transfer to a 4 year university for a BA or BS degree
Plan to complete a 2 year program (AA or AS degree) at Cabrillo or other community college and then work
Plan to attend a trade school and then work
Plan to go to work full time after graduating from high school
Choose the best answer that describes your plans.
To which colleges have you applied? List them in order of preference
*
University/College
Accepted
1
2
3
4
5
6
7
8
Where will you be living next year?
*
With my family
On Campus
Off Campus
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Activities
List the organization and activities you have participated in during high school. Include offices held and grade level.
Grade
Club
Student Government
Sport
1
2
3
4
5
6
7
8
List any Honors / Awards or special recognitions you have received while in high school.
Brief Description
1
2
3
4
5
6
7
8
Community Service/Volunteer Activities
Agency
Hours
Describe what you did
1
2
3
4
5
Work Experience
Employer
Job Title
Hours per Week
Date Range of job
1
2
3
4
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Additional Student Information
Special Circumstances
Are there any special circumstances that you believe would help the committee in its decision? (Examples: annual medical expences, disabled sibling or parent, natural disaster, AB540 status, additional responsiblities at home)
Essay
Upload a ONE PAGE statement regarding your academic objectives, future goals, and aspirations. Your student statement is very important and the Scholarship Committee relies heavily on this statement.
You may include the following:
What has shaped you as a person?
What are your educational and career goals?
Why have you chosen these goals?
Include any special circumstances or unusual hardships
How do you envision making a contribution to your community after you complete your education
Upload Your Essay Here
*
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Financial Information
PLEASE CONSULT WITH YOUR PARENTS IN ANSWERING THESE QUESTIONS. Many scholarships are based on financial need. If you do not provide the financial information requested below, you will not be considered for any scholarship in which need is a factor. In addition, students who will attend a 4-year university will be required to provide a copy of their awards letter in May.
Upload Important Documents
Required for NEED BASED Scholarships: Please provide a copy of your parents’ tax return and your student aid report from FAFSA.
Upload a copy of your parents 2011 tax return. (page 1 only)
Upload a copy of your student aid report from FAFSA. (page 1 only)
Have you submitted your FAFSA or plan on submitting your FAFSA?
*
Please Select
Yes
No
If no, why not?
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Parent Information
Your parents' current marital status is:
*
Married
Separated
Divorced
Widowed
Single
Father's Full Name
First Name
Last Name
Father's Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Father's Occupation
Father's Employer
Mother's Name
First Name
Last Name
Mother's Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Mother's Occupation
Mother's Employer
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Sibling Information
Number of brothers and sisters under 18 living at home and NOT going to college
*
Number of brothers and sisters going to college
*
Please provide information for one of your siblings who is currently attending college.
Sibling's Name
First Name
Last Name
Sibling's Age
Martial Status
Single
Married
Living arrangements
Residing at home
Residing away at college
Person or source providing major support?
Name of college that your sibling is attending?
Year in college?
Additional Aid your sibling receives
If applicable, provide information on another sibling who is currently attending college.
Sibling's Name
First Name
Last Name
Sibling's Age
Martial Status
Single
Married
Living arrangements
Residing at home
Residing away at college
Person or source providing major support?
Name of college that your sibling is attending?
Year in college?
Additional Aid student receives
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Financial Information Continued...
What is your Expected Family Contribution (EFC)
What is your family's 2011 annual income?
What was your family's untaxed income and benefits? (unemployement, child support, disability, etc.)
What were your family's medical and dental expenses not covered by insurance or Medi-Cal?
Have you received any other financial aid, scholarships or awards? If so, please specify.
Name of Scholarship, Financial Awards, Financial Aid, etc
Amount
1
2
3
4
5
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Submission and Certification
All the information is true and complete to the best of my knowledge.
Student's Electronic Signature:
*
Parent's Electronic Signature:
*
Submit
Should be Empty: