Fallen Hero Scholarship Program Application

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This application is ONLY for the children or spouses of CHP Fallen Heroes. To access the General Scholarship Program Application please visit our scholarship page at www.chp11-99.org/scholarships.
Biographical Info
Applicant Name*
First Middle Last
Birthdate*
mm/dd/yyyy
Date Format: MM slash DD slash YYYY
Gender*
- Female
- Male
Ethnicity*
Name of Fallen Hero*
(parent or spouse who was killed in the line of duty)
First Last
Applicant's Relationship to Fallen Hero*
Applicant Hometown City (in CA)*
County*

Intended School/Institution
Name of School*
Enter the name of the school or institution you plan to attend for the coming Fall and academic year.
School Type*
Federal School Code*
(typically 6 digits) If you do not know your school's code, you may look it up in the Federal School Code Search on the FAFSA web site at https://fafsa.ed.gov
School City*
School State*
Academic Status
Status for 2020-2021 Academic Year*
- Freshman/First Year
- Sophomore/Second Year
- Junior/Third Year
- Senior/Fourth Year
- Graduate Student
Cumulative College GPA*
Must be 2.7 or higher to qualify unless attending a trade/technical/vocational school
Major or Emphasis
ACTION REQUIRED - Official Transcript*
Please order an Official Transcript for the most recent academic institution you attended. Must be received no later than April 15, 2021 in our office.
- I have ordered or will order an Official Transcript from my school.
Transcript Format/Method of Delivery*
- Digital (preferred) Attn Bri Esquivel, 11-99 Scholarship Manager, scholarship@chp11-99.org
- Mail (must be in a school-sealed envelope)
When can we expect to receive your official transcript?*
Date Format: MM slash DD slash YYYY
Financial Info
Estimated Total Tuition Cost for year (Fall '21 - Summer '22)*
Please enter a number greater than or equal to 0.
Estimated Total On-Campus Cost for year (Fall '21 - Summer '22)*
Enter dollar amount
Estimated Total Books & Fees Cost for year (Fall '21 - Summer '22)*
Enter dollar amount

Applicant Contact Information
Email*
Enter Email Confirm Email
Phone*
Phone Type*
- Cell
- Home
- Business/Office
Personal Statement
Response - Why are you seeking to further your education and how do you plan to utilize it?*
(250-350 words)
Introduction Video Link*
Please create an introductory video of yourself for the Scholarship Committee. The video should NOT be professional or post-produced/edited. An amateur, 60-second video taken on a smart phone or laptop camera will be sufficient. Save the link to be pasted below here. YouTube or Vimeo only.

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