Instructions All application materials must be received no later than JANUARY 28, 2009. Postmarked dates will NOT be honored Mail Application & Support Materials as a COMPLETE packet to: Kaiser Permanente Diversity Scholarship Program PO Box 378066 Denver, CO 80247-8066 All application packets must include the following: (Use this form as a packet checklist) A completed 2009 Kaiser Permanente Diversity Scholarship Program Application: all requested fields complete (all fields must be completed!  If a field does not apply, please mark in the field - NA) signed Signature Form (with current name and current date) A completed 2009 Kaiser Permanente Diversity Scholarship Program Eligibility Form Completed Colorado residency fields (Guidelines established by the Colorado Department of Higher Education state that Colorado residency is determined by the student and/or parents or legal guardian residing within the state of Colorado boundaries.  An individual must have been domiciled in Colorado for one calendar year before he/she can be considered a Colorado resident.  Applicant must be a resident during time of the application process.)   One recent letter of recommendation from the current academic year dated between June 2008 – January 2009 letter should be from an academic, professional or community reference attesting to your academic, professional work, or volunteerism along with your personal character qualities completed reference contact form (included in packet) printed on letterhead signed by reference Official Transcript copy of most recent academic transcript (high school, undergraduate, graduate or doctoral) or GED certificate weighted cumulative grade point average 2.7 or above, or G.E.D score of 520 or higher printed from Registrars Office stamped with the institution’s official seal printed transcripts from the internet or Xerox copied transcripts will be disqualified unweighted or pass/fail grading systems must be converted to weighted grades on 4.0 grade scale An official transcript is a summary of your cumulative grades to date.  Official transcripts are printed form the Registrars Office, and include the official institution seal and/or signature of the current Registrar.  Most transcripts come in a sealed envelope.  An official transcript IS NOT a Xeroxed copy of an official transcript, printed from the internet, or without an official seal List of volunteer activities completed community involvement form listed activities must be between the dates of June 2007 – January 2009 activity contact information must be provided (all fields must be completed) Complete answers to three essay questions A copy of the most recent Free Application for Federal Student Aid (FAFSA), Student Aid Report (SAR), or income tax forms from 2008 Failure to provide any of the requested INFORMATION OR supporting documentation will result in IMMEDIATE disqualification Questions? Please refer to the Frequently Asked Questions (FAQs) section of the application. If your question is not answered in the FAQs feel free to e-mail us at: co-diversitydevelopment@kp.org   Contact us at: co-diversitydevelopment@kp.org Copyright 2006 - 2008 Kaiser Permanente