Please read: Please allow enough time to complete this online application. This application cannot be saved, we recommend that once you complete this online application that you print a copy of what you have submitted. You cannot be timed out when applying online.
MCCCD is an EEO/AA Institution

This scholarship is available to individuals who meet at least one of the following eligibility criteria, please check all that apply to you:

Foster Care - Young adults 18-25 years old, who have been raised in the child welfare system and are responsible for their own financial support.
 Physical Disabilities - College-age youth or adults with physical disabilities.
 Adults with Dependents - Adults 25 years or older with dependents in their family unit .


Applicants must also meet all of the following requirements:

Must be admitted to any one of the Maricopa Community Colleges.
Be working toward your first college degree with the intent to seek degree completion at the institution to which you are applying.
Be a U.S. citizen and a resident of Arizona.
Demonstrate financial need, as determined by the FAFSA, with priority given to those with a household income of 80 percent or less of the median income for Maricopa County (approximately $41,250). If your annual household income is greater than this amount, however your FAFSA results indicate financial need, then you may still apply.
Have previously completed no more than 24 college-level, degree-applicable credits (this includes current semester credits enrolled in at the time of application).

Personal Data

  
  First Name Middle Name Last Name

Permanent Address

  
  Street Address Apartment: City:
State: Country Postal Code
   
  Primary Phone: Secondary Phone: Email:
   

Qualifications

  
  Are you a US Citizen? Yes No Are you an Arizona Resident? Yes No
  Date of Birth:  Month Day Year Age
  Marital Status Single Married Divorced Widowed
  Are you physically disabled: Yes No
  Nature of Disability
  Do you require auxiliary aids or services related to your disability? Yes No
 
If yes, please explain:
 

Have you ever been under the care of the child welfare system/ward of the court? (see eligibility definitions for clarification.)

Yes No  If yes, in what state

  Do you have any dependents? Yes No   If yes, how many dependents do you have?
  If yes, what are their ages?
 

Dependent 1 Dependent 2 Dependent 3 Dependent 4

Dependent 5 Dependent 6 Dependent 7 Dependent 8

   
Income
Information
  
  Gross Annual Household Income as stated on your 2008 tax return (1040):
  Do you have any means of support other than that listed above? Yes No
  If yes, please explain:
  Did you file a FASFA (Free Application for Federal Student Aid)? Yes No
Academic
Information
  
 

In the fall of 2009, I will be attending: My MEID is:

I plan to attend:   Fulltime(12 credits or more) 3/4 time (9 credits) Parttime (6 credits or less)

I have completed a total of credits.

  Date of High School Graduation or GED (mm-dd-yyyy):  
  Name of High School
   
 

List any other colleges or universities you have previously attended:

Name of School Credit Hours Earned:

  Name of School Credit Hours Earned:
  Name of School Credit Hours Earned:
   
Employment
Information
  
  1)  Current Employer Position Hours per week
  Dates of Employment  to
  2) Previous Employer Position Hours per week
Dates of Employment  to
   
School/Community
Activities
  
  Please list the school or community activities in which you have been most involved in:
  Name of School or Community Organization:
  to
  to
 

Awards Received:

Year awarded

Year awarded

How did you
hear about the
Nina Mason
Legacy Scholars
Scholarship?
 

Essay Question: Please discuss, in 1-2 typed pages, based upon one or more of the eligibility criteria (as listed on the top of this application), how you qualify for the scholarship. What are your life goals and how will obtaining a college degree further these goals? How do you plan to balance your personal and academic responsibilities? What support systems do you currently have/need to help you succeed?

(Please note: we encourage you to use a word processor and to cut and paste your essay below.)
 

Almost done!

Submit the following to complete your application process. Incomplete applications may not be reviewed for additional questions e-mail: nina.scholars@domail.maricopa.edu.

Program application checklist:

1) Online application
2) Essay (in the box)
3) Unofficial Transcripts
4) Two Recommendation Forms  Click here to access the Recommendation Form
5) Complete a FASFA application. Click here to access the online FASFA Application.
6) Mail a copy of your 2008 tax returns

Mail Documents to:

Maricopa Community Colleges
Nina Scholars Program
2411 West 14th Street
Tempe, AZ 85281
 

Before submitting your application, please click "Print" on your browser window to have a copy of this application.

The Maricopa County Community College District does not discriminate on the basis of race, color, religion, national origin, sex, sexual orientation, handicap/ disability, age or Vietnam era/disabled veteran status in employment or in the application, admission participation, access and treatment of persons in instructional programs and activities.