Scholarship Application

County of Residence

Before applying, please verify the county that you live in. If your county is not listed, you will not be eligible.

Select County *

Personal Information

Please fill in the following personal information.

May we text you or call you? *

Yes

No

Ethnicity and Race / Gender / Employment Status

To be able to qualify for this scholarship, you are urged to identify your ethnic background, gender and employment status.

Ethnicity *

Gender *

Citizenship Information

Reminder: You must be a U.S. citizen, permanent resident, or qualified DACA status immigrant to apply for this scholarship.

Are you a U.S Citizen, resident or qualified DACA? *

Yes

No

Academic Information

Please fill out your current academic status & information.

Student Status *

Name of nursing school accepted or attending? *

Date accepted to nursing program? *

How many credits do you currently have? *

What specific degree are you seeking? *

Expected graduation date? *

Expected credit load for year? *

Do you currently hold a nursing license? *

Financial Information

To determine eligibility we require the following financial information.

Adjusted Gross Household Income *

Number of family members in household? *

Number of family members attending college this year? *

Work History

Please list your work history for the past 5 years (or attach your resume with the application).

List work history.

Attach Resume

Choose File

Volunteer/Community Service Activities

Please list your volunteer/community service activities (or attach your resume with the application)

Please list your volunteer/community service activities

Scholarship Essay

Briefly describe how a scholarship would help you to reach your educational and professional goals. Identify your goals and needs clearly. This essay is given strong consideration in the decision-making process. Maximum of 500 words. Please upload resume below or email once complete to scholarships@ccfoundation.us

Essay Upload

Choose File

Signature

By typing my name below, I certify that the above information is accurate to the best of my knowledge. I authorize Cuidado Casero Foundation to verify my GPA and other information contained in this application to members of the Scholarship Committee. If selected to receive a scholarship, I agree to participate in promotional activities to publicize my awards, such as attendance at awards presentations and the use of my photos and other information in print and online publications produced by Cuidado Casero Foundation, Inc. and its affiliates.

Full Name For Signature *

Signature Date *

Thank you for submitting your scholarship application.

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