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Promotes the advancement of women through public, corporate, and civic life.
Latinas In Progress™ (LIP) Education Series
SCHOLARSHIP APPLICATION  DEADLINE: FEBRUARY 21, 2015
PLEASE USE BLACK INK OR TYPE
To apply for a scholarship, you must be a Latina and a Senior in high school who has attended all five
sessions of the HWNT-FW Latinas in Progress™ (LIP) Education Series, in addition to meeting the
requirements outlined in this application. (If a makeup session is completed, you must include the
documentation with this application packet.)
I.
PERSONAL DATA
Name:
(Last)
(First)
(Middle)
(Street)
(City)
(Zip)
Address:
Cell/Home
Phone:
Email address:
High School:
Parents’ Names:
(Father)
Number of Children at Home:
Father’s Occupation:
(Mother)
Number of Children in College:
Mother’s Occupation:
Family’s Gross Annual Income:
(Total of Parents’ income before taxes, plus any other sources of income)
Are you currently employed?
If yes, where?
Why are you working and on average, how many hours per week do you work?
Class of 2015 HWNT-FW Scholarship Application
II. ACADEMIC PERFORMANCE
1. Class Rank:
2. WEIGHTED GPA:
other scale)
out of
graduating seniors
on a scale of
(Indicate if you are on a 4.0 scale or
3. Enclose an official transcript with this application.
4. SAT Score: Math
Reading
Writing
Total
ACT Score:
Please attach a copy of your SAT and/or ACT scores. Only one test score is required for this
scholarship application.
III. SCHOOL AND COMMUNITY INVOLVEMENT
1.
Please list extracurricular school activities or organizations to which you belong. (Use a separate
sheet/resume if needed or add more lines below.)
2.
Please list activities or organizations outside of school to which you belong. (Don’t forget to
include the Class of 2015 Latinas in Progress Education Series! Use a separate sheet/resume if
needed or add more lines below.)
HWNT Fort Worth Chapter  PO BOX 1523 Fort Worth, Texas 76101  www.hwntfw.org
Copyright © 2012-15 Hispanic Women’s Network of Texas  All Rights Reserved
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Class of 2015 HWNT-FW Scholarship Application
3.
What honors, recognition, or awards have you received? (Use a separate sheet/resume if needed or
add more lines below.)
IV. COMMUNITY SERVICE
Please provide proof or documentation that you have completed a minimum of 15 hours of community
service during the 2014-15 school year that was completed prior to the scholarship application deadline.
A minimum of 15 hours is required for this scholarship application but feel free to include ALL hours
of service from the 2014-15 school year. Don’t forget to indicate volunteer hours with HWNT.
Some examples of acceptable community service include: HWNT, church, hospital, food bank, senior
citizen center, Red Cross, YWCA, library, neighborhood association, middle or elementary school, etc.
V. REFERENCES
Please list three personal references. References can be teachers, counselors, employers, ministers, or
activity/organization leaders, etc. (References from family members, friends, or close acquaintances
are not allowed.) Please ask each of your references to complete the Reference Form. Be sure to
include your name, address, and phone number on the Reference Form before you give the forms to
your references. Your reference should return a sealed and completed Reference Form for you to
submit to HWNT Scholarship Committee by the required deadline. An optional letter of
recommendation may be included with the form. (Your reference can also mail their completed
Reference Form directly to the Scholarship Chair at the address listed on the form.)
HWNT Fort Worth Chapter  PO BOX 1523 Fort Worth, Texas 76101  www.hwntfw.org
Copyright © 2012-15 Hispanic Women’s Network of Texas  All Rights Reserved
3
Class of 2015 HWNT-FW Scholarship Application
1.
(Name)
(Address)
(Telephone)
(Name)
(Address)
(Telephone)
(Name)
(Address)
(Telephone)
2.
3.
VI. ESSAY
Please type a minimum one full-page essay on the following topic using LIP Education Series
Guidelines for Essay Writing.
Topic: Discuss a significant person, experience, or achievement that has meaning for you.
VII. COLLEGE/UNIVERSITY PLANS
You must have applied to the appropriate university before our scholarship deadline in order to be
considered for either the TCU Community Scholar Award or the Texas Wesleyan Scholarship.
Which HWNT-FW Scholarship Awards are you interested in receiving?
Application Status: Check box of
Scholarship Name
Description
Have you applied? Scholarship(s) you
(Indicate Yes or No) wish to receive
Full tuition, 4 years
TCU Community Scholar
(GPA & other requirements apply
Award
for renewal)
Texas Wesleyan Scholarship
HWNT-FW Scholarships


Half tuition, 4 years
One-time monetary award that can
be applied to college tuition or for
reimbursement of any college
expenses
(example: $1,000 award applied
towards room & board at UT)
N/A

What other scholarships have you applied for?
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
HWNT Fort Worth Chapter  PO BOX 1523 Fort Worth, Texas 76101  www.hwntfw.org
Copyright © 2012-15 Hispanic Women’s Network of Texas  All Rights Reserved
4
Class of 2015 HWNT-FW Scholarship Application
Which other scholarships have you received?
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
What are your career interests and intended field of study?
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Please select the colleges or universities where you have applied and indicate whether you have been
accepted:
1st Choice Name of School:
Have you been accepted?
Yes
2nd Choice Name of School:
Have you been accepted?
Yes
3rd Choice Name of School:
Have you been accepted?
Yes
VIII.
Have you applied?
Yes
No
Have you applied?
Yes
No
Have you applied?
Yes
No
No
No
No
HWNT SCHOLARSHIP AGREEMENT
I understand that any money awarded to me will be paid directly to the accredited institution I have chosen
to attend OR will be reimbursed to me after I show proof of tuition payment. I must enroll for a minimum
of twelve college hours or vocational equivalent per semester (full-time student status.) Funds will be for
tuition, books, and school-billed fees. I understand that it is my responsibility to request funds in a timely
manner from HWNT so that they can be paid to my academic institution prior to any payment deadlines.
(Please allow one week for scholarship fund processing.)
The Scholarship Committee will review each application on an individual basis. Each application will be
reviewed and scored by three members of the committee. If a student has a mentor or a relative who is on
the Scholarship Committee, the mentor or relative will not be allowed to evaluate that application. The
committee’s decisions will be final and reviewed by the Scholarship Chair prior to notification of any award
recipient. Failure to submit a complete 2015 Scholarship Application may cause the Scholarship Chair
and/or committee to disqualify the application completely.
Scholarships will be awarded on a one-time basis for the upcoming school year and funds must be used
within one calendar school year. I understand that if I do not enroll or if I withdraw from school during the
time frame the scholarship was issued, any unused money will be returned to the Scholarship Fund of the
Hispanic Women’s Network of Texas – Fort Worth Chapter. I also understand that any additional
scholarship requirements of my academic institution must be met and maintained in order to receive
my scholarship.
HWNT Fort Worth Chapter  PO BOX 1523 Fort Worth, Texas 76101  www.hwntfw.org
Copyright © 2012-15 Hispanic Women’s Network of Texas  All Rights Reserved
5
Class of 2015 HWNT-FW Scholarship Application
I certify that all my responses are true and factual. If selected as an HWNT scholarship award recipient, I
will make efforts to give back to the LIP Education Series by volunteering at future sessions, being available
to future LIP students for interviews, or special appearances at other HWNT-FW events. In addition, I will
also keep the HWNT Education and Scholarship Chairs informed and updated with my address and contact
information.
(Signature of Applicant)
(Date)
HWNT Fort Worth Chapter  PO BOX 1523 Fort Worth, Texas 76101  www.hwntfw.org
Copyright © 2012-15 Hispanic Women’s Network of Texas  All Rights Reserved
6
Class of 2015 HWNT-FW Scholarship Application
2015 HWNT SCHOLARSHIP APPLICATION CHECKLIST
***IMPORTANT***
All of the following are required for submission of a complete application for review by the HWNT
Scholarship Committee. Make sure you include the following in your packet:
 Completed Application
 Essay
 Official Transcript
 Copy of SAT and/or ACT scores
 Documentation for Community Service
 Reference Form #1
 Reference Form #2
 Reference Form #3
DEADLINE FOR YOUR COMPLETED SCHOLARSHIP APPLICATION:
MUST BE RECEIVED BY HWNT-FW OR POSTMARKED BY FEBRUARY 21, 2015
Please bring your completed application materials to the HWNT Scholarship Chair at the last LIP
Education Series session or mail completed applications (postmarked by February 21, 2015) to:
HWNT Fort Worth Chapter
Scholarship Chair
PO Box 1523
Fort Worth, Texas 76101
Questions or more information, contact the HWNT Scholarship Chair at [email protected].
HWNT Fort Worth Chapter  PO BOX 1523 Fort Worth, Texas 76101  www.hwntfw.org
Copyright © 2012-15 Hispanic Women’s Network of Texas  All Rights Reserved
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