Pittsburgh Metropolitan Area Hispanic Chamber of Commerce Foundation E-Mail: scholarships@pmahcc.org ● Fax: (412) 255-3701

The PMAHCC Foundation Scholarship Program accepts applications for the annual scholarship program from January 1 until April 30 for the scholastic year starting in the fall. This form will serve as an application. Students must respond to all PMAHCCF requests for verification and transcripts in order to be eligible.

Grant amounts are evaluated for each applicant depending on individual need or merit; and the foundation available funds. Not all applicants will be selected as recipients.

QUALIFICATIONS
To be eligible to apply to the scholarship program, applicants must:
	Currently attend, enrolled in or accepted into in an accredited post-high school educational institution** including 2 or 4 year college or university or vocational, technical or trade school in the United States or its territories
	Currently reside or have certain and established plans to reside in one of the following counties: Allegheny, Armstrong, Beaver, Butler, Fayette, Westmoreland or Washington County
	Demonstrate unmet financial need of at least $1,000 after the financial aid award package has been determined
	Have at least one parent of Hispanic ancestry (at least one of applicant’s grandparents must be Hispanic) 	Have a minimum cumulative grade point average of 3.0
	Enroll as a full-time student
	Community involvement is require

** Approved accredited institutions are defined as Title IV eligible, accredited, postsecondary two- or four-year colleges or universities, vocational, or technical schools in the United States.

AWARD
	Recipients of the Scholarship will be awarded one grant of up to $2,000, payable directly to the school the recipient is currently enrolled in or has been accepted to.
	Qualified candidates, including past recipient awardees, may re-apply every year, provided applicants meet the requirements described above. Awards are not renewable.

APPLICATION
Applicants must complete the application, along with the following required documentation, and deliver all documents and materials to the PMAHCCF via electronic or regular mail (described in detail below), by April 30 of each year. Applications received after the deadline (April 30) will not be considered or accepted. In addition to a completed application form, applicants must provide the following:
1. CURRENT, COMPLETE TRANSCRIPT OF GRADES ANY ONE OF THE FOLLOWING:
	Official or unofficial transcript; or Student-generated online transcript of grades that includes the student and school’s name. Grade reports are NOT accepted.
	GED Test score results

2. TYPE AN ESSAY OF NO MORE THAN 300 WORDS ANSWERING THE FOLLOWING QUESTION:       How has your Hispanic background affected the way you approach education and see the world?

APPLICATION DEADLINE INFORMATION
All application documents and information MUST be received by April 30 of every year in which the applicant is applying. For more submission information and details, please refer to the addresses listed below in page 2.

All information received is confidential and is reviewed only by authorized PMAHCCF personnel. The PMAHCCF’s Scholarship Selection Committee selects the recipient of the Scholarship after assessing each application received. All decisions are final.

Rev November 2019

NOTIFICATION OF AWARDS
THE SELECTED RECIPIENT OF THE SCHOLARSHIP WILL BE NOTIFIED BEFORE AUGUST 1.

PMAHCCF WILL NOTIFY GRANT RECIPIENT AT THE HOME AND/OR E-MAIL ADDRESS PROVIDED IN THE APPLICATION.

IF THE RECIPIENT DOES NOT RESPOND TO REQUESTS FOR VERIFICATION OF INFORMATION, OR ANY OTHER CORRESPONDENCE FROM THE PMAHCCF, AFTER TWO NOTIFICATION E-MAILS/LETTERS FROM PMAHCCF, THE SELECTED RECIPIENT WILL FORFEIT THE AWARD TO AN ALTERNATE RECIPIENT.

IF YOU PLAN ON LIMITING YOUR AVAILABILITY FOR ANY REASON DURING THIS RELEVANT TIME PERIOD, PLEASE NOTIFY THE PMAHCCF.

AWARD PAYMENT PROCESS

The Scholarship award is payable directly to the educational institution on which the recipient is enrolled in or accepted into, and such payment will be made at the beginning of the Fall Semester.

OBLIGATIONS OF RECIPIENT

Recipient agrees to have her/his name disclosed as the recipient of the PMAHCCF’s Scholarship to the media, including, but not limited to, newspapers, Facebook, Twitter, other social media, PMAHCCF’s website, founders and sponsors, or any other means of communication.

REVISIONS
PMAHCCF reserves the right to review the conditions and procedures in connection with the Scholarship and to make changes at any time, including, but not limited to termination of the Scholarship.

QUESTIONS, ADDITIONAL INFORMATION

Questions or additional information regarding PMAHCCF Scholarship Program should be addressed to:

PMAHCCF Scholarship Program E-Mail: scholarships@pmahcc.org Webpage: http://pmahcc.org

Complete application, along with the required documentation, all documents and materials must be deliver to the PMAHCCF via E-mail, Fax or Regular Mail (described below), by April 30 of each year.

Applications received after the deadline (April 30) will not be considered or accepted.

E-MAIL YOUR COMPLETED APPLICATION TO: scholarships@pmahcc.org

OR FAX YOUR COMPLETED APPLICATION TO: 412-255-3701

OR MAIL YOUR COMPLETED APPLICATION TO: PMAHCCF Scholarship Program One Oxford Center 301 Grant St Ste 4300 Pittsburgh PA 15219

IF MAILING YOUR APPLICATION, PLEASE SEND IT VIA REGULAR MAIL. WE DO NOT RECEIVE CERTIFIED OR FEDEX MAIL AT OUR VIRTUAL OFFICE.

Rev November 2019

PITTSBURGH METROPOLITAN AREA HISPANIC CHAMBER OF COMMERCE FOUNDATION 2020 STUDENT SCHOLARSHIP APPLICATION
TYPE OR PRINT ALL INFORMATION EXCEPT SIGNATURES	APPLICATION DEADLINE APRIL 30

A. About You

APPLICANT DATA

FIRST NAME_________________________M I________LAST NAME_________________________

MAILING ADDRESS, WHERE YOU RECEIVE YOUR REGULAR MAIL

STREET AND NUMBER___________________________________________________________________

CITY_____________________________________ COUNTY__________________________________

STATE_________ ZIP CODE______________________

BEST TELEPHONE TO CONTACT YOU_________________________________________________________

BEST EMAIL ADDRESS TO CONTACT YOU______________________________________________________

DATE OF BIRTH (MM/DD/YYYY)____________________________________

PLEASE INDICATE YOUR GENDER (FOR STATISTICAL PURPOSES ONLY)

ARE YOU THE FIRST MEMBER OF YOUR FAMILY TO ATTEND COLLEGE?

MALE	FEMALE

YES	NO

HAVE YOU FILED FOR A PMAHCCF GRANT PRIOR TO THIS YEAR?	YES, IN (YEAR)___________	NO

HAVE YOU COMPLETED THE FREE APPLICATIONFOR FEDERAL STUDENT AID (FAFSA)	YES, DATE FILED_____________ NO

ARE YOU AN INDEPENDENT STUDENT (I.E. SELF SUPPORTING)?	YES	NO

IF YES, HOW MANY DEPENDENTS? ____________

HIGH SCHOOL YOU ATTEND OR ATTENDED: ____________________________________________________

HISPANIC ANCESTRY

ARE YOU, YOUR PARENT(S) OR GRANDPARENT(S) HISPANIC? WHICH NATIONALITY? PLEASE ELABORATE

____________________________________________________________________________________

____________________________________________________________________________________

ARE YOU FLUENT IN SPANISH?     YES     NO	READ?     YES NO	WRITE?     YES     NO

PARENTAL DATA

DO YOU LIVE WITH BOTH PARENTS?     YES     NO

NUMBER IN HOUSEHOLD (INCLUDING APPLICANT/PARENTS/SIBLINGS/CHILDREN) __________

NAME OF PARENT/GUARDIAN, IF UNDER 18 YEARS OLD_____________________________________________

BEST TELEPHONE TO CONTACT YOUR PARENT/GUARDIAN __________________________________________

BEST EMAIL ADDRESS TO CONTACT YOUR PARENT/GUARDIAN_______________________________________

INCOME	PLEASE PROVIDE HOUSEHOLD ANNUAL INCOME AS REPORTED ON THE IRS TAX RETURN.

$__________________________(PLEASE DO NOT LEAVE BLANK)

Rev November 2019

B. Your Schooling	Name:__________________________

1.	HIGH SCHOOL OR EDUCATIONAL INSTITUTION YOU ARE ATTENDING NOW

__________________________________________________________________________________________

GRADUATION YEAR_________________ OR GED

WHAT IS YOUR CUMULATIVE GPA? _______________________ON A SCALE OF:_____________________________

2.	NAME OF THE EDUCATIONAL INSTITUTION YOU WILL BE ATTENDING THIS FALL:

______________________________________________________________________________________________

IS THIS A:	4 YR. COLLEGE OR UNIVERSITY	2 YR. COMMUNITY OR JUNIOR COLLEGE	VOCATIONAL/TECHNICAL SCHOOL

WILL YOU BE ENROLLED AS A: FULL-TIME STUDENT	PART-TIME STUDENT

WHAT IS YOUR INTENDED MAJOR(S)?____________________________________________________________________

WHEN DO YOU EXPECT TO GRADUATE? YEAR____________________________

YEAR IN SCHOOL THIS COMING FALL: (CIRCLE ONE)	1	2	3	4	5	OR	GRADUATE

C. Your Programs and Activities
PLEASE LIMIT YOUR RESPONSES TO THE SPACE PROVIDED

1.	LIST EXTRACURRICULAR ACTIVITIES, ANY OFFICES HELD, AND HONORS OR AWARDS YOU HAVE RECEIVED DURING YOUR HIGH SCHOOL AND/OR COLLEGE EDUCATION.

2.	ARE YOU, AT PRESENT, THE RECIPIENT OF ANY SCHOLARSHIPS OR THE BENEFICIARY OF ANY OTHER FINANCIAL AID? IF SO, PLEASE SPECIFY.

Rev November 2019

C. Your Programs and Activities	Name:__________________________ PLEASE LIMIT YOUR RESPONSES TO THE SPACE PROVIDED

3.	DESCRIBE ANY EMPLOYMENT (AFTER-SCHOOL, SUMMER, COLLEGE CO-OP) YOU HAVE HAD DURING THE PAST TWO YEARS.

4.	DESCRIBE ANY COMMUNITY-RELATED ACTIVITIES IN WHICH YOU PARTICIPATED AND YOUR ROLE IN THEM.

5.	WHAT ADDITIONAL INFORMATION (NOT ALREADY ADDRESSED IN THE APPLICATION) DO YOU WISH TO SHARE WITH THE SCHOLARSHIP REVIEW COMMITTEE.

Rev November 2019

HONESTY CERTIFICATION AND AUTHORIZATION

Student Name: ______________________________________________________

I acknowledge decisions of PMAHCCF concerning the scholarship application and recipient selection process are final and not subject to any form of appeal. I certify that I meet the basic eligibility requirements of the program and the information provided is complete and accurate to the best of my knowledge. Falsification of information may result in the termination of any scholarship I am granted.

I also authorize the Financial Aid office of my school to release to PMAHCCF information on my financial aid status, and I authorize the Pennsylvania Higher Education Assistance Agency to release information contained on any financial aid application filed with PHEAA. This information will remain confidential.

Name of Educational Institution you will be attending this Fall and the FINANCIAL AID OFFICE (FAO) Address, Phone, Fax and e-mail:

Educational Institution: ________________________________________________________________

Financial Aid Office Address: ___________________________________________________________

___________________________________________________________________________________

FAO Phone: _______________________________ FAO Fax: ________________________________

FAO E-Mail: _________________________________________________________________________

Student’s Signature_______________________________________________ Date________________

Parent’s Signature (If Applicant Is Under 18)_____________________________ Date_______________

Please verify the items, which you should have enclosed with this application. Only those applicants who have submitted all the items listed below will be considered for a scholarship award.

□ COMPLETED AND SIGNED APPLICATION FORM. □ TYPED ESSAY OF NO MORE THAN 300 WORDS. □ CURRENT, COMPLETE TRANSCRIPT OF GRADES

Applications must be in our e-mail inbox or at the virtual office on or before April 30. Incomplete or late applications will not be considered. (Late=received after April 30)

E-MAIL YOUR COMPLETED APPLICATION TO: scholarships@pmahcc.org

OR FAX YOUR COMPLETED APPLICATION TO: 412-255-3701

OR MAIL YOUR COMPLETED APPLICATION TO: PMAHCCF Scholarship Program One Oxford Center 301 Grant St Ste 4300 Pittsburgh PA 15219

IF MAILING YOUR APPLICATION, PLEASE SEND IT VIA REGULAR MAIL. WE DO NOT RECEIVE CERTIFIED OR FEDEX MAIL AT OUR VIRTUAL OFFICE.

Rev November 2019