Rolling Scholarship Application Spring 2013 |1
SAC Student Services
Rolling Scholarship Application
Please Note: Scholarship funds are extremely limited. Please ensure that all parts of the
scholarship are filled out completely for full consideration.
A limited number of scholarships are available. The Rolling Scholarship is designed to
meet the needs of students in good academic standing who have extreme financial need
yet may not have access to traditional funding sources. A limited number of small award
amount scholarships will be granted until funds are exhausted.
Eligibility Criteria:
 Currently enrolled at Santa Ana College
 Students in good academic standing have a minimum 2.0 cumulative grade point average
 Have extreme financial need with limited access to traditional funding sources


How to Apply:
 Access the online “Rolling Scholarship Application” from the Scholarship Program web site
www.sac.edu/scholarship
 Complete the application
 Include a one page statement with the following information
 major
 educational goal
 career goal
 financial need situation
 specific amount needed for the semester
Include supporting financial information (parents/self IRS 1040 tax forms)
Include your college transcript or for new freshmen students your high school transcript
Where to apply:
 Submit completed application to Scholarship Program S-201
Santa Ana College Scholarship Program (714) 564-6478
Rolling Scholarship Application Spring 2013 |2
Please Note: Scholarship funds are extremely limited. Please ensure that all parts of the
scholarship are filled out completely for full consideration.
____________________________________________________________________________________
(LAST NAME)
(FIRST NAME)
(MIDDLE)
_____________________________________________________________________________________________________
(STREET ADDRESS)
(CITY)
(ZIP)
_____________________________________________________________________________________________________
(PHONE NUMBER)
(DATE OF BIRTH)
(AGE)
(STUDENT NUMBER)
_____________________________________________________________________________________________________
(MESSAGE NUMBER – OPTIONAL)
(E-MAIL ADDRESS)
Centennial Education Students
Are you a former Centennial Education Student?
Select Semester:
Fall _______
or
Yes_____________ No_____________
Last Semester Attended: ____________
Spring _______
EDUCATIONAL INFORMATION:
LIST COLLEGE MAJOR: ________________________________LIST CAREER GOAL:________________________________________________
(Example: Teacher, CPA, Nurse, Lawyer, etc.)
Grade Point Average: _______________ Attach a copy of your transcript – (Unofficial copies of college or high school accepted)
Fee Status Information: (On Registration Statement)
_____ AB540 _____ U.S. Citizen _____ Care & Control _____ Permanent Resident _____ F1 Visa
_____Other
_____ Decline
Funding
Do you receive any of the following funding sources?
_____ Board of Governors Fee Waiver (BOG)
_____Free Application for Federal Student Aid (FAFSA)
_____ Scholarships: Source/Amount__________________________________________________________
Continuing Student:
Did you submit an application for the annual Scholarship Competition? Yes________
No____________
Leadership:
(Please list any school office that you have held and /or Club or Team that you have been a member while at Santa Ana College.)
Community Activities: (Please list community activities that you have participated or volunteered.)
Rolling Scholarship Application Spring 2013 |3
***PERSONAL STATEMENT***
Attach a one-page personal statement explaining your special financial need situation.
Financial Information: Please select the category that best describes your income situation. Students who filed tax
information and dependent students who parents’ filed tax information for 2011; please attach the first two pages of your
tax return.
_____Independent
-Student not claimed on another’s income tax form. Attach a copy of your latest IRS 1040 form.
_____ Dependent
-Student claimed on another income tax form. Along with a copy of your IRS 1040 form, attach
a copy of your parents or guardians latest IRS 1040 form.
_____ Unavailable tax information
-Students not a part of an income tax return form please complete the following information.
______ Receive state aid do not file
______ Other do not file
Supporting documentation (state award letter, W2 forms) helpful but not required

Family Size (How many in family) ______________

Annual Estimated Income $________________
_____ F1 visa Student – no additional income information is required.
_____ Decline to provide financial information
Financial Request:
List the specific amount needed for the semester. Scholarship funds are limited, but please list the amount of fees and/or
cost of book(s) that you are requesting. Please keep in mind that award amount are meant to cover one book or minimal
fee assistance.
Amount of funds requested for Fees:_______________
Amount of funds requested for Books:_______________
I hereby certify that the information contained herein is true and accurate to the best of my knowledge and I authorize the
Scholarship Program to review my official transcript (s) and all other data pertaining to the application. I also authorize
Scholarships to review, use, and release my application information with academic records to scholarship donors. I
acknowledge that all the information provided is given freely and may be used by the donors to determine eligibility.
____________________________________________________
_________________________
Applicant’s Signature
Date