Tom Bradley Scholarship | ACEBSA Scholarship | LA City Worker Scholarship

TOM BRADLEY SCHOLARSHIP

First African-American Mayor of Los Angeles

"Never give up. Keep your thoughts and your mind always on the goal..."

Tom Bradley Scholarship Fund Annual Scholarship Criteria

Applicant must submit a completed application
Applicant must submit an official sealed copy of their grades/transcripts with application
Applicant must submit two (2) Letters of Recommendation with application
Applicant should exhibit a high degree of scholastic achievement and merit
Applicant must show proof of acceptance to a College/University
Applicant must continue studies at an accredited two of four year College, Trade, Professional or Graduate School
Applicant may possibly be given preference according to their financial need.
Scholarship award must be used for tuition and/or purchases for educational supplies needed at the Trade/Professional School, Junior College, University or Graduate School the applicant shall attend.
The amount of the scholarship award will be determined by the Scholarship Committee and approved by the All City Employees Charitable Organization.
Scholarship awards shall be disbursed December 15, 2011

SCHOLARSHIP DEADLINE:
A COMPLETED APPLICATION (PRINTED, SIGNED, AND DATED), TWO (2) LETTERS OF RECOMMENDATION, AND GRADES/TRANSCRIPTS ON SCHOOL/COLLEGE LETTERHEAD MUST BE RETURNED TO THE ACEBSA OFFICE NO LATER THAT 12:00 NOON ON DECEMBER 2, 2011, NO EXCEPTIONS.

For more information or to obtain an application, please contact the All City Employees Benefits Service Association at (213) 485-2485 or visit our website at www.acebsa.org.

SCHOLARSHIP ONLINE APPLICATION FORM:

PERSONAL INFORMATION

NOTE: If you do not have information to complete a required field, or the question asked is "Not Applicable" to you, please enter “N/A” accordingly.

Date: (mm/dd/yyyy)

First Name: Middle Name: Last Name:

Current Mailing AddressStreet: City: Zip Code:

Home Number: Work Number: Cell Number:

Birth Date: (mm/dd/yyyy) California Driver's License No: Expiration Date: (mm/dd/yyyy)

Name of ACEBSA Member: ACEBSA Membership No.:

U.S Citizen

Yes No Pending

City Employee

Yes No

Social Security NoLast Four:

Marital Status Single Divorced Widowed Married

ACADEMIC INFORMATION

Name of present school attending or last school attended:

Years Attended: Grade Point Average:

Class Level Freshman Sophomore Junior Graduate

Are you planning to go to school Full Part-Time

Educational Goals

Proposed Educational Major: Minor:

Anticipated Degree: Anticipated graduation date: (mm/dd/yyyy)

Schools to which you have applied for the next academic year:

		Registered	Applied	Accepted
#1
#2
#3

Have you applied for any loans? Yes No if yes, list the amount:

Does your department reimburse for educational courses? Yes No
if yes, have you requested reimbursement? Yes No How much $

Have you received any scholarships, certificates or awards? Yes No

If yes, please list:

Type	Name of Organization	Amount	Year

List educational goals (college major, etc.). City employees list your careers goals.

FINANCIAL INFORMATION

Describe Scholarships/Fellowship/Grants for which you		Annual Value	No. of Years
Have Applied:
Intend to Apply:
Will Receive:

FINANCIAL STATEMENTComplete estimated income and expenses for the academic year for which you are applying for scholarship:

INCOME		EXPENSES
Student’s Net Earnings	$	Tuition	$
Spouse’s Net Earnings	$	Academic Fees	$
Other Taxable Income	$	Books/Supplies	$
Other Taxable Income: Grants/Scholarships	$	Insurance	$
Sub-Total (Income)	$ 0.00	Child Care/ Other (Designate)	$
PARENTAL ASSISTANCE
Mother	$
Father	$
Joint Filling	$
Sub-Total (Parental Assistance)	$ 0.00
Total (Income + Parental Assistance)	$ 0.00	Total (Expenses)	$ 0.00

WORK EXPERIENCEShow present or most recent employment first

Employer	Type of Work	Hrs/Week	Net Weekly Pay

If working part-time when do you expect to obtain full-time employment?
Working Part-Time. Full Time Employment Date: (mm/dd/yyyy)
Not Working Part-Time
Working Full Time
Working Part-Time. No Full-Time Employment Date.

CURRICULUM ENHANCING ACTIVITIES IN COLLEGE AND HIGH SCHOOL

Describe Activity	College/High School	Year

COMMUNITY ACTIVITIES

Describe Activity	Agency/Group/School	Year

HONORS / AWARDS

Describe Activity	School/Other	Year

Submit two (2) written references, preferably from teachers or professors from your current or most recent school.

State your goals and plans to reach them.

Explain what education means to you. Include individual qualifications and the need for you to succeed and/or contribute to your chosen field.