Scholarship Nomination Form NameFirstLastAddress*Phone*WHAT UNIVERSITY, COLLEGE OR TRADE SCHOOL DO YOU PLAN TO ATTEND? IF YOU CURRENTLY ATTEND A COMMUNITY COLLEGE, WHAT COLLEGE DO YOU ATTEND?FIELD OF STUDYCAREER PLANS AND GOALSPLEASE PROVIDE US WITH INFORMATION ON WHAT VOLUNTEERISM AND COMMUNITY SERVICE YOU HAVE CONTRIBUTED WITHIN THE SAN FERNANDO VALLEY. (Include sponsoring organization, description of project(s), dates, and hours spent)COMMUNITY SERVICE REQUIRED BY SCHOOLCOMMUNITY SERVICE AND VOLUNTEER WORK OF YOUR CHOICESCHOOL ACTIVITIESHIGH SCHOOL/COMMUNITY COLLEGESTUDENT GOVERNMENT (Student body and/or class)CLUBS AND ORGANIZATIONSATHLETICSADDITIONAL ACTIVITIESAWARDS, HONORS AND OTHER ACHIEVEMENTSOTHER COMMUNITY ACTIVITIESEMPLOYMENTRELIGIOUS ACTIVITIESADDITIONAL ACTIVITIESARE THERE ANY SPECIAL CIRCUMSTANCES THAT SHOULD BE KNOWN TO THE SCHOLARSHIP COMMITTEE WHEN CONSIDERING THIS APPLICATION?ADDITIONAL COMMENTSPerson Submitting (If different than student)NameFirstLastAddressPhoneEmail addressSendThis field should be left blank