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Instructions

All application materials must be received no later than JANUARY 4, 2010.

Postmarked dates will NOT be honored

Mail Application & Support Materials as a COMPLETE packet to:

Kaiser Permanente Colorado Diversity Scholarship Program
PO Box 378066
Denver, CO 80247-8066

All application packets must include the following:

(Use this form as a packet checklist)

__ 1. A completed 2009 - 2010 Kaiser Permanente Colorado 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)

__ 2. A completed 2009 - 2010 Kaiser Permanente Colorado Diversity Scholarship Program Eligibility Form

__ 3. 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.)

__ 4. One recent letter of recommendation from the current academic year

dated between June 2009 – January 2010
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

__ 5. 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

__ 6. List of volunteer activities

completed community involvement form
listed activities must be between the dates of June 2009 – January 2010
activity contact information must be provided (all fields must be completed)

__ 7. Complete answers to three essay questions

__ 8. 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