www.calstatela.

edu/org/surge

Students United to Reach Goals in Education

surge@calstatela.edu

SURGE is proud to present its quarterly scholarship. Since 2008 the availability of funds have made possible to increase the number of scholarships from 4 to and an increase from !200 to !"00 per scholarship. #e than$ to all SURGE members and allies that have made this possible by %ettin% involved in the fundraisers throu%hout the quarter& by buyin% from SURGE 'a$e sales or (ust by donatin% money. )i$e SURGE& this scholarship hopes to aid Undocumented Students in their educational e*perience at +alifornia State University of )os ,n%eles. SUBMISSION INFORMATION -our complete application pac$et must be submitted in a sealed envelope .ith your name to the SURGE /ffice room 20012there .ill be a try .here you can place the envelope3. Applicants receiving t is sc olars ip will !e noti"ied during t e "irst S.U.R.#.$. %eeting& w ic will !e eld t e second wee' o" t e Spring will ta'e (uarter )*+* and will !e awarded at SUR#$, s Open -ouse& w ic SURGE via email at sur%e5calstatela.edu.
$.I#IBI.IT/ 0RIT$RIA

place on April& )*+*. 4f you have any further questions or concerns please contact

6o be considered for the SURGE Scholarship& applicants must meet all the follo.in% criteria7 0. 'e an Undocumented Student8,' 40 Student or an ,llie 2. 9ave attended 6hree consecutive SURGE :eetin%s for the 2000 #inter ;uarter ". Sho. proof of enrollment for the #inter ;uarter 2000 at +alifornia State University of )os ,n%eles. , copy of the applicant<s schedule printed from the GE6 system can fulfill this requirement.

1+12 State Universit3 4rive Room "0= ,ttention SURGE )os ,n%eles& +, >00"2

www.calstatela.edu/org/surge

Students United to Reach Goals in Education

surge@calstatela.edu

0. 4n case that the applicant cannot present a proof of enrollment at the time of turnin% in the application& the student has until the first SURGE meetin% of Sprin% 2000 to present the proof. 4. 'e in %ood academic standin%& meetin% a 2. transcript from GE6 required3. . 1ill out attached questioner describin% your participation in SURGE activities 0. ?articipation8involvement committee and events. 2. ?articipation8involvement .ith @ream 6eam )os ,n%eles ". 4nvolvement in the other committees and activities also count as participation. =. ,ttach a =00 .ord essay 202B font& 6imes Ae. Roman& @ouble spaced& 0B mar%ins3 in .hich the applicant .ill ans.er the follo.in% questions please ma$e sure to ans.er all ". 2 Applicants %ust NOT write t e top rig t corner o" t e -eader57 0. #hat is your intended ma(or and .hy did you chose itC 2. :ention a stru%%le that you had or are facin% and ho. did you overcome it or ho. you are overcomin% it. ". 6ell us somethin% that has not been included in the application that you believe sets you apart from the other candidates. is or er na%e on t is essa3& instead please write t e last 2 digits o" 3our 0IN on the +alifornia @ream Aet.or$ and .ith the ,cademics presentations8 different minimum G?, 2Unofficial

Applicant In"or%ation
)ast Aame7 DDD DDD 1irst Aame

1+12 State Universit3 4rive Room "0= ,ttention SURGE )os ,n%eles& +, >00"2

www.calstatela.edu/org/surge +4A E ?lease BO.4

Students United to Reach Goals in Education

surge@calstatela.edu

@o you pay for your tuition as a resident of +aliforniaC - 8 A 4f -es& are you classified as an ,' 40 StudentC - 8 A 4f Aot& #hyC :ailin% ,ddress7 +ity and State7 F4? +ode7

:a(or8s E*pected year of %raduation 2 ?hone Aumber 3

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Applicant,s Financial Status

4n the follo.in% space briefly e*plain ho. do you intend to pay for your education or ho. are you currently payin% for your education. @o you .or$ to pay for tuition and educational e*pensesC @o you receive any type of help from parents& friends& or sponsorsC

Sc olars ips 6reviousl3 Awarded to t e Applicant.

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Students United to Reach Goals in Education

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Students United to Reach Goals in Education

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STAT$M$NT OF A00URA0/ 4 hereby affirm that all the above stated information provided by me is true and correct to the best of my $no.led%e. 4 hereby understand that if chosen as a scholarship .inner& the money .ill be use only for academic purpose. Aame of ,pplicant7 Si%nature R$M$MB$R
T e deadline "or sc olars ip application to !e received is 9999999 6lease su!%it in a sealed envelope wit 3our na%e and address at t e SUR#$

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%ail!o: provided at t e SUR#$ o""ice roo% )*+A& t ere will !e tra3 especiall3 "or t e sc olars ip envelopes.

1+12 State Universit3 4rive Room "0= ,ttention SURGE )os ,n%eles& +, >00"2