Irene Mercado Scholarship App. - Women's Southwest FCU
Student: please print or type-
(c) 2004 Cal Feminist FCU
(c) 2010 Women's Southwest FCU
Full Legal Name
of Student _____________________________________________________
Student ID # ___________________________
What would you like us to call you? ___________________
City ______________________________________State___ Zip_______
What makes you eligible to apply for this scholarship? (check boxes)
1. I am the [ ]daughter [ ]niece [ ]granddaughter [ ]sister [ ]mother [ ]grandmother of:
She/he is the primary owner of WS share account #__________________. It has a
balance of at least $25. She/he [ ]is [ ]is not a member of--or related to a member of--
WSFCU's Supervisory Committee, Board of Directors, Credit Committee, Scholarship
Committee, staff, or other WSFCU officers.
[ ] 2. I am a woman who is the primary owner of WSFCU share account #________________.
It has balance of at least $25.
Please attach: (1) a detailed 12-month budget beginning with the month
before you will start or return to school; (2) a paragraph of up to 50
words describing how your educational program will improve your life.
DO NOT include any other enclosures.
I certify that all information provided is true and correct. I agree that
Women's Southwest Federal Credit Union may use my name and
photograph (which I will provide) for publicity purposes if I am selected
as a scholarship recipient.
Date Student's Signature
Area/Program/Type of Study_______________________________
Length of Program___________________________________________
Date Next Session starts____________________
If approved, between which dates should your school or school /bookstore
receive our check? From (date) ____________ through __________
School You Plan to Attend_____________________________________
School Phone #_______________________________
School Web site: _____________________________________________
School Mailing Address_______________________________________________
Check Payable To*________________________________________
*Note: if you win, our check will not be paid to you; it will be paid directly to your school