Future Connect Application

If you meet the eligibility requirements for the Future Connect program and would like to apply, please fill out the form below. This is a secure form to ensure the safety of your personal information. This application will not be saved if closed. Please be prepared to complete the entire application then click submit when finished.

Priority deadline for the scholarship application is March 31, 2015.

Student Identity Information

Last Name*
First Name*
Middle Name
Date of Birth*
(MM/DD/YYYY)
MHCC Student ID # *
If you have not yet applied for Admission to MHCC, please do so now.

Student Contact Information

Mailing Address:*
City *
State*
Permanent Phone*
Alternate Phone
Email Address*

Student Demographic Information

Gender*
   
Race/Ethnicity*




High School/GED Information

Current (or last) high school or GED Program attending*
Expected Graduation Date

Program Participation

What Summer Works or Summer Youth Connect program(s) have participated in?*
Please check all that apply. NOTE: We will verify your program participation to help determine your scholarship eligibility.


























Career & College Plans

Major Field of Study* If you have two, or have a double major, please indicate that as well. If you are undecided, simply state "Undecided".
Career Plans* Enter your planned career, e.g., auto mechanic, forensics, geriatrics, social work, sports writing, teaching, etc. If you are undecided, simply state "Undecided".
Intended Enrollment for Fall 2015* Do you intend to enroll at MHCC for fall classes, 2015? If you do not attend MHCC in fall 2015 then you will not be eligible for this scholarship.

   
Enrollment Status* The amount of classes you are enrolled in will not affect your scholarship eligibility.

   

Personal Information

Father's Schooling History* Has your father completed a college degree (A.A. or B.A./B.S.)?


   
Mother's Schooling History* Has your mother completed a college degree (A.A. or B.A./B.S.)?

   
Household Information* Does anyone in your household currently receive any of the following? Please check all that apply.






Living Situation*

Do any of the following describe your living situation? Please check all that apply:



Estimated Family Income*

Please give an estimation of your family's annual income.








   
Have you completed a Financial Aid Application (FAFSA) for 2014-2015 school year? A Financial Aid application must be completed, and on file, to be accepted as a Future Connect scholarship recipient.

   
Did you select MHCC as the school choice on this application?
   

Essay Questions

1. Why do you want to go to college?.*
 
2. Describe a challenge or obstacle you faced in the last ten years. What did you learn about yourself from this experience?*
 

3. Describe a personal accomplishment and the strengths and skills you used to achieve it.*
 

4. Explain how you have helped your family or made your community a better place to live. Please provide specific examples.*
 

Certification and Agreement

This certification takes the place of a signature. By answering "Yes" to each of the questions below, you certify that you have read, understood, and agree to the following certification statements.
I certify the accuracy of this completed application form and all accompanying documents, and, if requested, agree to provide proof of this information.
   
I give permission to the selection committee to contact my high school and selected Summer Youth Connect affiliated programs to verify this information.
   
If selected to receive a scholarship, I give permission for a publicity release such as newspaper articles, agency promotional materials or reports.
   
I understand that I will be ineligible for this scholarship if I do not enroll in MHCC fall 2015.
   
   
© 2014 Mt. Hood Community College | 26000 SE Stark St. | Gresham, OR 97030 | 503-491-6422