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AAA Arizona ¡Si Se Puede! Scholarship Application
SECTION 1: INITIAL SCHOLARSHIP ELIGIBILITY
Please print or type your application and answer every section. Incomplete applications will not
be considered. Applicant must meet all of the following criteria.
• Be Hispanic or of Hispanic descent
• Be a U.S. citizen
• Be an Arizona resident
• Be an Arizona high school senior
• Be (or plan to be) enrolled full time as an undergraduate student in Arizona for the
upcoming academic year in an accredited college or university.
• Have earned and maintained a cumulative grade point average of no less than 3.0 on
a 4.0 scale
SECTION 2: GENERAL STUDENT DEMOGRAPHIC INFORMATION
Name_______________________________________________________________________
Last
First
Middle
Home Address____________________________________________________________
Street
City, State
Zip
Date of Birth _____________ Home Phone ____________________
Email address_____________________________
How did you learn about the scholarship? ____________________________
I am the first in my immediate family to attend college: □ Yes □ No
I am currently a high school senior: □ Yes □ No
I plan to attend _______________________ for the ______________, ______semester and
College/University
Summer, Spring, Fall
Year
plan to enroll in ________credits.
I am seeking a(n): □Associate’s Degree
Projected Completion Date: ______________________
Major/Academic Program of Study________________ □Plan to transfer to: ______________________
by________________________
□Bachelor’s Degree Projected completion date: __________________
Major: ___________________________________
Arizona Resident: □Yes □ No
Gender:
□ Female
Status:
□ Single
U.S. Citizen □Yes □ No
□ Male
□ Married
□ Single Parent
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SECTION 3: PERSONAL STATEMENT OF INTENTIONS AND GOALS
Attach no more than (2) two pages, typed, describing in your own words your career goals and
commitment and how the AAA ¡Si Se Puede! Scholarship will help attain them.
SECTION 4: PLEASE INCLUDE WITH APPLICATION ALL OF THE FOLLOWING:
•
•
•
•
•
Official high school transcript
Copy of letter of acceptance to school or proof of enrollment
Two (2) letters of recommendation
Proof of citizenship
Statement of intention and goals
Submit completed application with the above information to
internalcommunications@arizona.aaa.com; or mail to AAA Arizona, Attn: Internal
Communications, 2375 E. Camelback Road, Ste. 500, Phoenix, AZ 85016; or fax to 602-7760466. Applications must be received by April 4, 2014.
The above statements are true and correct to the best of my knowledge.
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Applicant Signature
Date
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Parent or Guardian Signature (if not 18 yrs of age or older)
Date