Guardian Scholars Program Application

Application materials must be submitted or postmarked on or before November 30th, to receive priority consideration. You may hand-deliver your completed application and support materials directly to the Guardian Scholars Office located in the Titan Bookstore, Commons 120, or you may mail your completed application to California State University, Fullerton; Guardian Scholars Program; P.O. Box 6828 C-120; Fullerton, CA 92834-6828. An official high school or community college transcript must be submitted with the Guardian Scholar application materials.

• First Name __________ Middle Name __________ Last Name __________

• Address ________________________________________________________

• City __________ State __________ Zip __________

• Phone __________ Cell or Message __________ Email __________

• Age __________ Date of Birth __________

• School currently attending(name, city, state) ___________________________

• CSUF Admission application submitted: Filed paper format Filed electronically

• Class level at time of planned enrollment: Incoming Freshman Transfer Student Other ________

• Grade Point Average:___________

• Current SAT score:_________ Date taken or to be taken:_________

• Current ACT score:_________ Date taken or to be taken:_________

• County of origin: Orange Los Angeles San Bernardino Riverside Other _______

• Amount of contact with biological family: Regular contact Limited contact No contact

• Plan for housing while attending Cal State Fullerton (check one): Dorms/on-campus Apartment/off-campus With friend or relative

• Current source of financial support (mark all that apply): Foster family/group home Employment Other _____

• Average hours worked per week last year (enter zero if unemployed): __________

• Total earnings between January through December last year: __________

• Current medical coverage (mark all that apply): Cal-Optima Medicare Private health insurance No insurance of any kind

• How did you learn about this scholarship? ILP Foster family Relative Social worker Orangewood Foundation Other _____

RECOMMENDATION LETTER OF REFERENCE

• Name __________ Relationship __________ Phone __________

• Name __________ Relationship __________ Phone __________