Inspiring Young Minds † Educating Tomorrow’s Leaders



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Inspiring Young Minds ☼ Educating Tomorrow’s Leaders

Scholarship application type:

a) Academic merit ◊

or

b) Cultural merit ◊

Application deadline September 16, 2017

APPLICANT

First Name Middle Name Last Name

_______________________________________________________________________________

Home Address

_______________________________________________________________________________

City State Zip Code

_______________________________________________________________________________

Tel. # E-mail

_______________________________________________________________________________

Date and place of birth (city, state & country) sex:

_______________________________________________________________________________

Citizenship Status: □ U.S. Citizen

□ U.S. Permanent Resident

Is a Language other than English spoken at home? □ Yes □ No

If yes, please specify: ____________________________________________________

1200 Palm Harbor Pkwy-Palm Coast, FL 32137

Tel. (386) 446-3910



paccscholarshipcomm@

PARENT’S INFORMATION

Father’s full name and place of birth (city, state, and country)

________________________________________________________________________

Mother’s full maiden name and place of birth (city, state, and country)

________________________________________________________________________

Home tel. # PACC membership #

________________________________________________________________________

Grandparent birthplace

___________________________________

CURRENT HIGH SCHOOL/COLLEGE

School Name

________________________________________________________________________

City State

________________________________________________________________________

Academic year & major Expected Graduation Date

________________________________________________________________________

COLLEGE/UNIVERSITY/INFORMATION

Name the college or university you are registered to attend the fall and spring semesters.

Use official school names. Do not use abbreviations.

School Name and complete address (for student accounts)

________________________________________________________________________

__________________________________________ student ID#__________________

COMMUNITY SERVICE AND EXTRACURRICULAR SCHOOL ACTIVITIES

List all school activities in which you have participated in the past four years (e.g. student government, music, sports, etc.). List all community activities in which you have participated without pay for the past four years (e.g. Boy/Girl Scouts, hospital volunteer, Senior Center, food drive, animal shelter, Special Olympics). Be sure to note any special awards and honors received, and any title or office held.

Activity Description No. of yrs. participated

_______________________________________________________________________

Activity Description No. of yrs. participated

RECOGNITIONS

Briefly elaborate on the activity you have found to be the most meaningful to you.

_______________________________________________________________________________

_______________________________________________________________________________

______________________________________________________________________________________________________________________________________________________________

Special Awards/Honors

______________________________________________________________________________________________________________________________________________________________

ESSAY (Required)

An essay with no less than 300 words, must be included with this application, detailing proof of Portuguese Ancestry, and interest in the Portuguese language and culture and plans for contributing to the Portuguese-American Community after the completion of your studies.

ATTACHMENTS

Along with a printed, signed and dated application, the applicant must submit a number of documents to ensure that a fair and unbiased evaluation is made. The student is responsible for submitting all materials on time, to the Portuguese American Cultural Center of Palm Coast, Inc. “Scholarship Fund Committee”. This application for a scholarship becomes complete and valid only when P.A.C.C. has received all of the following materials:

◊ Two recent letters of recommendation addressed to PACC from any of the following sources: guidance counselor, teacher, principal, coaches, ministers or community business leader. These letters should address your character, academic and or community promise and achievements.

◊ YOUR MOST RECENT OFFICIAL HIGH SCHOOL OR COLLEGE OFFICIAL TRANSCRIPTS INCLUDING GRADING SCALE AND ALL AVAILABLE SAT SCORES.

◊ Essay as mentioned above, with attached proof of Portuguese Ancestry (omit if previously submitted).

◊ A recent photo of applicant, suitable for printing.

◊ Proof of service hours performed at P.A.C.C. of Palm Coast.

ELIGIBILITY REQUIREMENTS FOR AN ACADEMIC MERIT SCHOLARSHIP

1. P.A.C.C. family member: The applicant must be a member or a legal child of a paid P.A.C.C. member, in good standing, for at least the past two full consecutive calendar years.

2. Proof of Portuguese Ancestry, from a least one parent, grandparent or great-grandparent. (omit if previously submitted)

3. Citizenship status: Must be a U.S. Citizen or Permanent Resident.

4. Applicant must be an accepted full time student, with a 12 credit minimum per semester to an accredited College or University or currently enrolled; and the total number of scholarships received from P.A.C.C. cannot exceed (4) four.

5. Student must carry a minimum 3.0 GPA cumulative at time of application submittal. For high school students, SAT scores may be taken into consideration in the case of a tie.

6. Applicant must perform 10 hours of service to the Portuguese American Cultural Center of Palm Coast, and be available to work on the day of ceremony, October 14th, 2017. This requirement must be completed before December 31st, of the current year. Award is contingent on fulfillment of this requirement. Service hours form shall be signed by the organization director or Scholarship Committee Chairperson.

7. Attendance at Scholarship Banquet is required to receive the award and proper attire is recommended.

ELIGIBILITY REQUIREMENTS FOR A CULTURAL MERIT SCHOLARSHIP

1. P.A.C.C. family member: The applicant must be a member or a legal child of a paid P.A.C.C. member, in good standing, for at least the past two full consecutive calendar years.

2. Proof of Portuguese Ancestry, from a least one parent, grandparent or great-grandparent. (omit if previously submitted)

3. Citizenship status: Must be a U.S. Citizen or Permanent Resident.

4. Applicant must be a student, to an accredited Institution or currently enrolled; and the total number of scholarships received from P.A.C.C. cannot exceed (4) four.

5. Student must have a substantial and active involvement in the Portuguese American Cultural Center of Palm Coast, and be available to work on the day of ceremony, October 14th, 2017.

6. Attendance at Scholarship Banquet is required to receive the award and proper attire is recommended.

7. Award is contingent on fulfillment of these requirements.

The Portuguese American Cultural Center of Palm Coast, Inc., Scholarships are awarded to qualifying students who demonstrate an eagerness to succeed in their chosen fields and are proud of their heritage, and believes it is never too late for Portuguese Americans to connect to the rich cultural heritage of their parents, grandparents, or great-grandparents.

DEADLINE: Deliver the above attachments with your application, by September 16, 2017 to: Portuguese American Cultural Center of Palm Coast, Inc. 1200 Palm Harbor Parkway, Palm Coast, FL 32137

Attn: Scholarship Committee

I acknowledge decisions of the Portuguese American Cultural Center of Palm Coast, Inc. Scholarship Committee are final. I certify that I meet the basic eligibility requirements of the program as described in this application and that the information provided is complete and accurate to the best of my knowledge. If requested, I agree to provide proof of information I have given in this application.

________________________________________________________________________

Applicant Signature Date

________________________________________________________________________

Parent Signature Date

PORTUGUESE AMERICAN CULTURAL CENTER OF PALM COAST, INC.

SCHOLARSHIP FUND

RECORD OF SERVICE HOURS

NAME: ________________________________________

Date No. of hours duties Location

1. ___________________________________________________________________

2. ___________________________________________________________________

3. ___________________________________________________________________

________________________________________________________________________

Signature and title of Organization Director date

Tel. #____________________________

________________________________________________________________________

Signature and title of Organization Director date

Tel. #____________________________

________________________________________________________________________

Signature and title of Organization Director date

Tel. _____________________________

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