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I certify that the information provided is correct to the best of my knowledge. I understand that consent is given to Mesa Community College to release academic, financial, or any other necessary information to assist the Scholarship Committee in making its selection. All information is confidential and will only be used to assist in the selection process.
If you do not require any aids or services, please answer, "No".
If you are not physically disabled, please answer, "Not applicable".
Are you a current participant or graduate of the Maricopa ACE (Achieving a College Education) Program?
Are you working toward your first college degree?
Please select one of the options below that best describes your current enrollment status for the study abroad program at Mesa Community College.
Have you completed the FAFSA for this fiscal year?
Have you completed an application to the England, France, and Scotland Study Abroad Program at Mesa Community College?
Are you majoring in an MCC Business and Information Systems department program? These include: General Business, Real Estate, Computer Information Systems, Web Technology, Networking, and other areas
Do you receive scholarships, financial aid, or any type of tuition assitance?
Must attend a minimum of four events (select one option below):
Option 1: Four Workshops - Four completed workshops from Connect 4 Success, Financial Aid, Career Services, Counseling, Learning Enhancement Center, and/or MesaCan (A New Leaf). Alternative workshop(s) must be pre-approved by a Connect 4 Success staff member.
Option 2: Four Tutoring Center Visits - Four visits each semester at a minimum of one hour per visit to an MCC tutoring site such as Learning Enhancement Center, Math & English Tutoring Centers, and/or Academic Skills Center. Alternative tutoring sites must be pre-approved by a Connect 4 Success staff member.
Option 3: Combination of four events - Attend workshops and tutoring center visits that equal 4 events at a minimum of one hour per event.
What is your citizenship status?
Are you a graduate of a high school in the state of Arizona or hold a GED diploma?
Have you ever participated in a Mesa Community College study abroad program before?
Have you ever participated in a Mesa Community College study abroad program before?
Have you signed a 2015-2016 Women's Track and Field NJCAA Letter of Intent?
To select multiple items, hold control or command and click each one.
Have you completed a 2018-2019 FAFSA application?
Have you ever been under the care of the child welfare system (foster care) or been a ward of the court?
For the purposes of this scholarship program, Child Welfare System is described as the public-supported system that serves neglected, abused, abandoned, at-risk children and/or those who are wards of the courts. A person who has experienced time in the child welfare system may have lived in an institution such as a group home, child protection agency, or special facility for children, and/or with a foster family. This applies particularly to those persons who were raised away from their biological parents or relative caregivers for extended periods of time, were financially supported by sources other than their families, and are presently responsible for themselves financially. This does not include applicants and/or their biological parents receiving TANF, food stamps, or other state aid such as AHCCCS.
Which program will you be majoring in?
Answer what year you received your High School or GED, if you have neither just answer n/a
Have you signed a 2018-2019 Men's Soccer NJCAA Letter of Intent at Mesa Community College?
What is your Cumulative Grade Point Average?
Have you met with your mentor at least three times this semester?
What College / University are you currently attending?
Answer this question based on the institution you are currently attending as of the date of this application.
Have you signed a 2017-2018 Women's Basketball NJCAA Letter of Intent?
What College/ University are you currently attending?
Answer the question based on your current enrollment status as of the date of this application.
Are you returning to college following an interruption of your education?
Do you have a mimimum cumulative GPA of 2.5?
Have you signed a 2018-2019 Women's Basketball NJCAA Letter of Intent?
Are you physically disabled?
I will complete the program in accordance with program guidelines and the Mesa Community College Student Code of Conduct. I will positively represent Mesa Community College throughout my participation in the program.
Have you completed Reading 071?
Are you an Interior Design Major?
Have you signed a 2018-2019 Women's Soccer NJCAA Letter of Intent?
If you have not been in the foster care system or were a ward of the court, please answer, "Not applicable".
Are you a graduate of a Mesa School District?
Have you completed at least one PHILOSOPHY or RELIGIOUS STUDIES course at Mesa Community College?
Are you currently enrolled in the second block of the nursing program?
Are you a United States citizen?
Have you signed a 2018-2019 Men's Track and Field NJCAA Letter of Intent?
I hereby authorize Mesa Community College Cashier Services to pay the following program with my current financial aid and/or scholarship:
Are you currently attending high school?
Answer the question as of today.
If you do not have any dependents, please answer, "Not applicable".
I understand that whether or NOT Federal Student Aid and/or scholarships are awarded, I am responsible for payment of all study abroad program fees by March 22, 2019. All scholarship funds will automatically be applied to your outstanding balance after your summer term begins. Funds cannot be issued prior to the official disbursement date regardless of your study abroad departure date. Failure to pay the debt may result in any or all of the following: 1) My debt may be turned over to a collection agency and/or attorney. 2) I may be reported delinquent to the credit bureau. 3) My state tax refund WILL be offset by the amount of debt.
Are you or will you be part of a club activity on your campus?
Certification Agreement
After my return, I will write a testimonial about my experience and what I gained from my experience and submit it to the Mesa Community Study Abroad Coordinator.
Are you an alumni that actively participated in the ACE (Achieving College Education) Program at Mesa Community College?
I hereby authorize Mesa Community College Cashier Services to pay the following incurred expenses for study abroad program fees from my financial aid grants, loans, and/or scholarship awards. All fees (tuition, fees, supplies, study abroad program fees, or other).
Have you signed a 2016-2017 Men's Baseball NJCAA Letter of Intent?
Can you commit to meeting an assigned Mentor in person (face to face) on campus for a minimum of three (3) times?
To select multiple items, hold control or command and click each one. Child Welfare System
For the purposes of this scholarship program, Child Welfare System is described as the public-supported system that serves neglected, abused, abandoned, at-risk children and/or those who are wards of the courts. A person who has experienced time in the child welfare system may have lived in an institution such as a group home, child protection agency, or special facility for children, and/or with a foster family. This applies particularly to those persons who were raised away from their biological parents or relative caregivers for extended periods of time, were financially supported by sources other than their families, and are presently responsible for themselves financially. This does not include applicants and/or their biological parents receiving TANF, food stamps, or other state aid such as AHCCCS that are not foster youth.
Physical Disabilities
A physical disability for the purposes of this scholarship program is one that limits or impairs a person's ability to access and/or be fully mobile on campus, and/or creates a special challenge for classroom instruction, tutoring, student support services, participation in campus offerings, and other academic and extracurricular activities. This includes disabilities that substantially limit major life activities such as walking, seeing, hearing, speaking, breathing, writing and working. These disabilities
may be results of, but not limited to, spinal cord injuries, brain injuries, speech impairments, visual impairments, hearing impairments, epilepsy, cerebral palsy, multiple sclerosis, muscular dystrophy, loss of limbs, and severe orthopedic injuries. Applicants are to provide official documentation of their physical disability from a medical or health care provider.
Adults with Dependents
These are adults who are 25 years of age or older and have dependents in their family units (self not included). These adults may be first-time college students or returning students (those with previous college experience). The family unit may include relatives or other persons who may live in or outside the applicant's household for whom the Internal Revenue Service has
determined there is a financially dependent relationship.
Do you meet Satisfactory Academic Progress (SAP)?
Have you completed an Individual Education Completion Plan (IECP) for your current degree at MCC?
The scholarship review committee requests a copy of your Individual Education Completion Plan (IECP) during the scholarship review process. The IECP is completed with the help of an academic advisor.
Provide name and address of high school you graduated from.
I understand that whether or NOT Federal Student Aid and/or scholarships are awarded, I am responsible for payment of all study abroad program fees by March 1, 2019. All scholarship funds will automatically be applied to your outstanding balance after your summer term begins. Funds cannot be issued prior to the official disbursement date regardless of your study abroad departure date. Failure to pay the debt may result in any or all of the following: 1) My debt may be turned over to a collection agency and/or attorney. 2) I may be reported delinquent to the credit bureau. 3) My state tax refund WILL be offset by the amount of debt.
Have you signed a 2016-2017 Men's Soccer NJCAA Letter of Intent at Glendale Community College?
Have you signed a 2017-2018 Volleyball NJCAA Letter of Intent?
Are you a first or second season participant?
Have you participated in student clubs and organizations, ASMCC, leadership retreats, co-curricular programs, and/or volunteered on campus.
Have you been formally admitted to the nursing program?
Are you working on your first Associates or Bachelors Degree?
Do you qualify for a Maricopa Community College District (MCCD) faculty, staff or dependent tuition waiver?
Are you admitted to the Mesa Community College Nursing Program?
Have you signed a 2018-2019 Women's Softball NJCAA Letter of Intent?
Have you completed more than 24 college level credits? (In order to qualify for this scholarship, applicants must not have more than 24 college level credits) College level credits are 100 level or above courses and can be applied towards an Associate degree. Developmental courses (i.e. MAT082, RDG081, ENG091) are not considered college level credits.
In order to qualify for this scholarship, applicants cannot have completed more than 24 college level credits.
College level credits are 100 level or above courses and can be applied towards an Associate degree. Developmental courses (i.e. MAT082, RDG081, ENG091) are not considered college level credits.
I certify that the information provided is accurate and correct to the best of my knowledge.
If you are not physically disabled, please answer "Not applicable".
Are you an alumni that actively participated in the HOL (Hoops of Learning) Program at Mesa Community College.
What is your cumulative Grade Point Average (GPA)?
Are you an Arizona resident, as determined by the admissions and records office?
Are you a Surprise Resident, city staffer, or Luke AFB Personnel?
If I am awarded a scholarship and/or grant and fail to maintain a passing grade in my study abroad program, I understand that I may be asked to return any MCCCD scholarship or grant funds that I have been awarded.
I will complete the program in accordance with program guidelines and the Mesa Community College Student Code of Conduct. I will positively represent Mesa Community College throughout my participation in the program.
For the purposes of this application, a single parent is defined as the sole provider and caretaker for one or more dependents under the age of 18. Are you a single parent?
Are you currently enrolled at Mesa Community College?
Are you part of the Maricopa-ASU Pathways Program (MAPP) transfer program to ASU?
Is your current enrollment equal to or greater than 9 credits (according to current MCC Nursing Department criteria)?
Are you currently meeting Satisfactory Academic Progress?
Students must successfully complete 2/3 (66.67%) of all attempted course work.
Are you a legal resident of Maricopa County?
I understand that if chosen, scholarship recipients will be asked to attend an East Valley Gardeners' Club meeting to receive the award.
Have you completed a 2019-2020 Free Application for Federal Student Aid (FAFSA)?
Are you actively participating in the Connect 4 Success program?
Active participation will be verified with C4S program coordinator.
Have you received an Otto & Edna Neely Foundation Scholarship in the past?
Are you enrolled at Mesa Community College?
Are you currently pursuing an Associate Degree in Applied Science (AAS) in Exercise Science and Personal Training or a Certificate of Completion as a Personal Training Specialist.
I authorize the Maricopa Community Colleges to release any necessary information to the International Education Office, donor and or Maricopa Community Colleges Foundation, as such entity may require.
Example: May 2011 (05/2011)
Do you have a documented disability?
Are you currently enrolled full -time (12 or more hours) at Mesa Community College?
Have you completed the Study Abroad Ireland 2019 online application?
Which of the following is your primary campus?
Example: Xalapa, Mexico in 2013
