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2017-2018 AB 540 Dream Scholarship Application
Name: ________________________________________________
Hancock student ID Number: H__________________
Address: _______________________________________________
City: _________________________ Zip Code: ________________
Home Phone: __________________________________
Cell Phone: ____________________________________
Date of Birth: __________________
Gender: Female ______Male _______
E-mail Address: _________________________________________
(award decision will be sent by email. Make sure your email address is legible and correct)
Academic Background
High School Attended: ____________________________ High School GPA: ___________
Number of Years Attended in a California High School: _____________
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Received Diploma or GED by August 2017:
Yes
No
Major: _____________________________________________
Career of Interest: ____________________________________
1. What is your current GPA? ________________
2. How many units do you plan to enroll in
Summer 2017________ Fall 2017 ________ Spring 2018 _________
3. How many units have you completed at Allan Hancock? ________________
4. Degree objective or goal: (Please check all that apply)
Certificate ___
Associates Degree ___
Bachelors Degree ___
5. Do you have a current Student Education Plan (SEP)? ______________
Please return application to Juanita Tuan at Allan Hancock College, EOPS office, Building A. (805)
922-6966 x3214