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Required*

1 Provide your personal information.

First Name *

Last Name *

Permanent Address *

Apt No.

State *

Zipcode *

Current Mailing Address *

Apt No.

State *

Zipcode *

Phone Number *

Email Address *

Name of College or University (this fall) *

Year Entering (this fall) *

Major Field of Study (this fall) *

Type of Degree (this fall) * Type of Degree (this fall)

2 Please answer the following questions:

Are you a current paid member of the Hawaiian Civic Club of Honolulu? *

Yes

No

Are you a relative of a member of the Hawaiian Civic Club of Honolulu? *

Yes

No

If “Yes”, what is the name of the member? *

What is the relationship? *

Have you received an HCCH Scholarship before? *

Yes

No

If so, what year(s)? *

3Upload your documents.

Upload files must be saved as a PDF and named in the following format : BC_FirstInitial.LastName.pdf.

Certified birth certificate *

Drop a file here or click to upload Choose File

Maximum upload size: 62.91MB

Official copy of most recent transcript *

Drop a file here or click to upload Choose File

Maximum upload size: 62.91MB

Is this transcript BEYOND the last 6 months? *

Yes

No

Please provide a short explanation (returning to school, family, etc.) *

Is your cumulative grade point average (G.P.A.) LESS than 2.5 ? *

Yes

No

Please provide a short explanation for consideration. *

Letter of recommendation *

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Maximum upload size: 62.91MB

Text

Please submit name and relationship of recommender to applicant. (Ie: Kamuela Yong, PhD; University Professor)

4 Extra Credit (5 points)

Identify HCCH activity(ies) you or your family members (that represented you if you were off island) participated in and provide a brief explanation of what you did. Check the activities attended below: *

Provide a brief explanation of what you did:

5Submit this application.

To the best of my knowledge, the information provided in this application is complete and correct. Furthermore, I agree: to provide any additional information required to support my application at the request of the appropriate, designated representatives of the Hawaiian Civic Club of Honolulu (HCCH); to give the HCCH the right to obtain any necessary and appropriate information from the school(s) in which I am enrolled and/or have been enrolled to make a determination of satisfactory academic progress; to release information from this application and essay as deemed necessary by the appropriate, designated representatives of the HCCH at their sole discretion.

If I am chosen as a recipient of a scholarship award, I give my permission to be a scholarship member of the Hawaiian Civic Club of Honolulu (HCCH). As a scholarship member, no membership dues will be required of me during my term as a recipient until I cease being a scholarship member. I will have no voting rights. I have no objection to receiving HCCH’s newsletters to learn about the activities of HCCH so that one day I may be able to contribute to the civic responsibilities in our community by way of a voting member of the HCCH.

Checkboxes *

I have completed the required documents needed to apply for this scholarship and understand the above statement.

Scholarship application 2024-2025

POST-SECONDARY SCHOLARSHIP APPLICATION FORM

1 Provide your personal information.

2 Please answer the following questions:

3Upload your documents.

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4 Extra Credit (5 points)

5Submit this application.