Scholarship Application - Pacifica Foundation Seattle

PACIFICA FOUNDATION SEATTLE

Scholarship Program Application Package for Living Allowance (i.e., room, transportation, grocery) – Taxable for the recipient

Dear Applicant,

Thank you for your interest in PACIFICA FOUNDATION SEATTLE Scholarship Program. Please fill out the application form completely. Please ensure that all supporting documents and your application are submitted via email to scholarship@pacificafoundationwa.org before August 31, 2023. Any falsification, misrepresentation, or omission may disqualify your application. The information you provide is confidential and will not be shared with any other person or company for any purpose. Unsigned and incomplete applications may result in denial of your application.

The scholarship application is open throughout the year, depending on the availability of funds. In order to be considered for PACIFICA FOUNDATION SEATTLE Scholarship Program, an applicant must submit all required documents as one package to the committee. Applicants will be notified if they have been selected based on the timeline provided on our website: https://www.pacificafoundationwa.org/scholarships.

First Name

Middle Name

Last Name

Date of Birth

Gender

Ethnicity

Permanent Address

Country

State

Zip Code

Phone

E-Mail

Please provide information regarding your current schools.

Current School

Address

Phone

Years attend from

Please provide information regarding your previous schools.

Previous School

Address

Phone

Years attend from

Employment

Employer

Job Position/Title

Employer’s address

Hourly/Monthly/Annual Income

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Have you ever been, or are you currently on academic probation?

If yes, explain

Do you have any other scholarships or receive financial aid?

If yes, please provide the amount and name of the institution.

Please list, if any, any honors, awards, or remarkable achievements (both academic and extracurricular):

Please list, if any, your talents, interests, hobbies, club memberships, and activities:

INFORMATION ABOUT YOUR PARENTS OR LEGAL GUARDIAN

Title

Full Name

Relationship to applicant

Address

Home/Cell Phone

Employer's Name

Job Position/Title

Employer's Address

Work Phone

Annual Income

Applicant lives with

Let us know who you live with

PACIFICA FOUNDATION SEATTLE
Scholarship Program Application Package

1. Application form (Above)
2. Resume
3. Most recent Official Transcript or acceptance letter to an accredited educationalinstitution in the state of Washington.
4. Proof of identification (driver’s license, passport, or national ID card)
5. Two letters of recommendation confirming the student’s compliance with theeligibility requirements
6. An essay summarizing the student’s opinion on Pacifica Foundation Seattle values aswell as any personal information that would be helpful for the committee to decideon the eligibility of the student for a scholarship
7. Most recent Tax Return from the family of the student (household income) and thestudent herself/himself). If the student’s parents are not in the USA, any official document and/or a personal letter demonstrating the need for financial aid is required.
We/I, the undersigned, hereby certify that, to the best of our/my knowledge and belief, the answers to the preceding questions and statements made by us/me in this application are complete and accurate. We/I understand that any false information, omissions, or misrepresentations of facts may result in rejection of this application or future dismissal of the applicant.

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Signature of Applicant

Date

Signature of Parent or Guardian (if the applicant is under 18)

Date

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