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PORTUGUESE STUDIES PROGRAM SCHOLARSHIPS AND FELLOWSHIPS

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					PORTUGUESE STUDIES PROGRAM SCHOLARSHIPS AND FELLOWSHIPS Luso-American Development Foundation Scholarships and Fellowships Pinto/Fialon Scholarship Fund Data Sheet/Application Form
Personal Data Name: Address:

Phone number: (

)

E-mail address: ______________________ Student I.D. Sex: ( ) Female ( ) Male

Social Security Number: Date of birth:

Registration status for 2008-2009 (please circle one): 1st year/freshman 2nd year/sophomore Transfer student _________ year 5th year/senior 3rd year/junior 4th year/senior

Graduate student

Field of study: _____________________________________________________________ I received an LADF scholarship or fellowship last year _______YES __________NO If you checked yes, you do not need to fill out the Portuguese background information or include documentation. However, please fill in GPA and attach a copy of your latest transcript (may be unofficial). Always notify PSP of your new address if you move. Eligibility Requirements I am: ( ) a Portuguese immigrant (please include copies of your immigration/naturalization paperwork); --or-- ( ) a son or daughter of a Portuguese immigrant (please include copies of your birth certificate and parental immigration/naturalization paperwork); --or-- ( ) Of Portuguese ancestry. (must be at least 1/8th Portuguese) --or-- ( ) a Portuguese student (please include copies of your student visa and passport) _______________________________________________________________________________ Current Grade Point Average: ______ Please provide a copy of your latest transcript. (An unofficial copy is acceptable.) Applicants must file the Free Application for Federal Student Aid (FAFSA) by the due date. (Not required for foreign students.) 2008-2009 Luso-American Development Foundation (LADF) Scholarships and Fellowships I authorize the University of California to release academic, financial, test scores, transcripts, and other supporting documents to the Portuguese Studies Program. ( ) YES ( ) NO Signature ____________________________________________________ Date __________________ Please return this form and copies of documentation to: Portuguese Studies Program Coordinator 249 Moses Hall, MC 2316, Berkeley, CA 94720-2316 e-mail: psp@berkeley.edu (510) 643-0980 (message); (510) 643-3372 (FAX)


				
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