Alice Newell Joslyn Medical Scholarship Application
Eligibility requires an applicant to be entering the Medical/Health Care profession i.e.; dental/medical assistant, nursing, physical theraphist, or seeking their Bachelor of Science, Master's or Doctorate in the health field. Applicantss must be living or attending a high school or college in San Diego County at the time of application. Eligibility is contingent upon a student's financial need, scholastic determination, and community/cultural awareness. Scholarships range between $500 to $2,000 per academic year. Scholarship recipients may re-apply contingent on scholastic progress.

PLEASE NOTE THIS IS A 3 PART APPLICATION PROCESS:
Part 1: Online application
Part 2: Submit essay and 2 letters of recommendation in PDF or word document form to scholarship@becafoundation.org by March 2, 2017.
Part 3: Mail official transcripts by March 2, 2017 deadline to BECA Foundation P.O. Box 936, Escondido, CA 92033.

First Name
Your answer
Last Name
Your answer
Birth Date
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DD
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YYYY
Address
Your answer
City
Your answer
Zip Code
Your answer
Cell Phone
111-111-1111
Your answer
Home Phone
111-111-1111
Your answer
E-Mail Address
Your answer
School Name
Entre the name of the school you are currently attending.
Your answer
City
Your answer
GPA
Your answer
Graduation Date
MM
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DD
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YYYY
When is your senior awards/ceremony night? Check with your high school counselor.
For high school students only.
MM
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DD
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YYYY
Colleges you have applied to for fall 2017 or college you are currently attending?
College Name
Your answer
College Name
Your answer
College Name
Your answer
Family's birthplace and ethnic origin:
Parent 1 Birthplace - Enter city and state.
Your answer
Parent 1 Ethnic Origin
Your answer
Parent 2 Birthplace - Enter city and state.
Your answer
Parent 2 Ethnic Origin
Your answer
Financial Information
Submit an electronic copy of your 2017-2018 Student Aid Report (SAR) that includes your Estimated Family Contribution (EFC) if you have already completed a FAFSA or DREAM ACT application. If not, complete the questions below. Failure to submit EFC or complete financial information below will result in an incomplete application.
Please select one:
What is your Estimated Family Contribution or EFC as determined by your FAFSA or DREAM ACT application?
Your answer
Financial information about the applicant.
Your 2016 taxable income.
Your answer
Your 2016 U.S. income tax paid.
Your answer
Your 2016 total untaxed income (e.g., AFDC, Social Security, Child Support).
Your answer
Your total cash, savings and checking account.
Your answer
Your total other assets (e.g., stocks, bonds, trust funds, real state equity and other investments).
Your answer
Number in your household including yourself.
Your answer
Number of college students in your household projected for fall 2017 (include yourself).
Your answer
Please provide parent's financial information ONLY if you are considered a dependent student.
Parent 1/Step-parent/Guardian's occupation?
Your answer
Parent 2/Step-parent/Guardian's occupation?
Your answer
Number of dependents in your parent's household?
Your answer
Number of college students in your parent's household projected for fall 2017 (include yourself)?
Your answer
Parent's/Step-parent's/Guardian's 2016 total taxable income
Your answer
Parent's/Step-parent's/Guardian's 2016 US income tax paid
Your answer
Parent's/Step-parent's/Guardian's 2016 total untaxed income (e.g., AFDC, Social Security, Child Support)
Your answer
Parent's/Step-parent's/Guardian's total cash, savings and checking account
Your answer
Parent's/Step-parent's/Guardian's real state equity (do not include principal residence where you live)
Your answer
Parent's/Step-parent's/Guardian's other assets (e.g., stocks, bonds, trust funds, other investments)
Your answer
If parents own a business, business value
Your answer
If parents own a business, business debt
Your answer
If there is anything significant about your family's financial circumstance that is not reflected in your prior responses (e.g, high uninsured medical expenses, changed income in 2016, unemployed) or if you are a dependent student and entered $0.00 income for parents please explain how the family supported itself. Be specific
Your answer
Certification
By entering my name below I certify that all of the information provided in this application is true and complete to the best of my knowledge. If asked, I agree to give proof of the information I have provided on this form. Please note that this will be considered your electronic signature.

Please remember this is a 3 step process. After submitting your online application you must submit your essay and 2 letters of recommendation to scholarship@becafoundation.org and mail official transcripts to BECA Foundation P.O. Box 936, Escondido, CA 92033.

Your application will not be considered complete if all 3 parts are not submitted by the MARCH 2, 2017 DEADLINE.

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