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Scholarship application
PERSONAL INFORMATION
List all former name(s) you may be known by (i.e. maiden name).
Date of Birth

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EMPLOYMENT GOALS




EMPLOYMENT INFORMATION


Please provide employer information below:                                            
EMPLOYMENT VERIFICATION

Valid verification of employment may include letter on letterhead from immediate supervisor, formal organization documentation from HR or other related department, or last two months pay stubs


File(s) must be uploaded to submit this application. 
Acceptable types of document format: .pdf, .docx, .jpeg, .tif, .txt must not exceed 25 megabytes


DEMOGRAPHICS
Providing demographic information does not affect your chances of admissions.  We collect demographics information for statistical purposes only.  This section is optional. 
ETHNICITY / ANCESTRY
To help us understand the diverse racial and ethnic backgrounds of our students, please tell us which of the following groups best describes your background. Select all categories that apply to you.  Remember, this information is used for statistical purposes only by UC, government agencies and researchers (not for admission purposes).

Includes persons of Cuban, Mexican, Puerto Rican, South or Central American or other Spanish culture or origin.

Which of the following groups best describes your racial background?  Check all that apply.







GENDER IDENTITY AND SEXUAL ORIENTATION
We're committed to ensuring our campuses are welcoming to all students.  As with all other demographic questions, providing your gender identity and sexual orientation is voluntary, optional, and not considered in admissions decisions.  

Any information you provide in this section will be used for statistical analysis and programmatic purposes only.


SCHOLARSHIP APPLICANT ACKNOWLEDGEMENT


Contact Information