APPLICATION
Bonnie Chastain Scholarship 16-17
College of San Mateo
Please read all questions carefully and answer them as completely as you can.
Your completed application will represent you to the Scholarship Committee. Please submit two
complete packets of all documents to the Creative Arts and Social Science Division Office in
Building 10 room 413 by Monday March 7, 2016 or submit via email to brownm@smccd.edu
by the due date.
GENERAL INFORMATION
Name:
(LAST)
(FIRST)
(MIDDLE)
Current Address:
ZipCode:
City:
Cell Phone:
Home Phone:
Student G #:
Date of Birth:
Spouse’s Name:
Marital Status:
Spouse’s Occupation:
Number of Children:
Children’s Ages:
Please complete the family data questions if you live with and/or are supported by your parents.
Father’s/Mother’s Occupation/s:
Number of brothers/sisters living at home:
Number of other people living at home:
Number attending college:
EDUCATION
Next FALL semester, you expect to:
Return to CSM,
Graduate,
At which college do you plan to enroll in the future?
What is your intended major?
What is your intended career?
Total college units accumulated at the end of the Fall semester:
Transfer
ELIGIBILITY
Female students who have taken 6 DGME credits in the broadcast concentration,
with at least 3 credits from a production-based course (indicated in bold) are eligible
to apply. Which of these DGME courses have you completed? Indicate your final grade
for each.
COURSES TAKEN
FINAL GRADE
DGME 100 Media in Society
_____
DGME 101 Writing Across the Media
_____
DGME 102 Media Law & Ethics
_____
DGME 112 TV Studio Production
_____
DGME 113 Digital Video Production
_____
DGME 118 Digital Audio Production
_____
DGME 120 Adv Digital Video
_____
DGME 128 On Air Talent
_____
DGME 155 Adv Studio
_____
Other _____________________________ _____
ACTIVITIES, INTERESTS, AWARDS, ETC.
List organizations, clubs, and extra-curricular activities in which you have been active
(school clubs, KCSM, youth groups, sports, drama, etc.):
What are your hobbies or special interest areas? _________________________
WORK EXPERIENCE
Are you currently employed? If so, list your employer, type of job, and hours per week:
List any other jobs or internships you have held within the past 5 years:
Employer
Job/Position Title
Dates of
Employment
Reason for Leaving
Bonnie Chastain Scholarship Application
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LETTERS OF RECOMMENDATION
Choose (2) persons to write letters of recommendation for you. It is strongly
recommended that one letter come from a faculty or staff member outside the
Broadcast & Electronic Media Department and one from a non-CSM member or nonfamily related individual who knows you through work or activities. (A high school
instructor and/or counselor is acceptable.) Have the letters sent to you so that you can
submit the recommendations with your scholarship packets.
PERSONAL STATEMENT
Submit a well-written and thoughtful personal statement that explains the following:
• Your reasons for applying for this scholarship
• Your plans for the future
• Your financial need to continue your education
• Any other information about yourself, family and/or your educational achievements
which will help the Scholarship Committee gain a more comprehensive background
about you
I have read the instructions and completed this application as accurately as possible. If
circumstances occur that change any of the information reported in this application, I
understand that I must report this to the Scholarship Committee.
Signature:___________________________________ Date: __________________
Bonnie Chastain Scholarship Application
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