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NJ GOVERNORS INDUSTRY VOCATIONS SCHOLARSHIP (NJ-GIVS) APPLICATION FOR WOMEN AND MINORITY STUDENTS
October 1, 2013
(Fall and Spring Term)
March 1, 2014
(Spring Term Only)
3. Race/Ethnicity: Please review text below and enter a number: _______ (See reverse for further information.)
1) Black, 2) Hispanic, 3) Asian American or 4) American Indian or Alaskan native
4. Social Security Number: __ ___ ___ - __ ___ - ___ ___ ___ ___ 5. Date of Birth: ______/______/______ 6. Current School Student ID Number: __________________________
____________________________________________________________________________________
CITY STATE ZIP CODE
10. Date of high school graduation or date of GED: ________________________ 11. New Jersey county college you are or will be attending: _________________________________________________
(See list of eligible colleges on reverse)
First
Second
13. Name of certificate program in which you are currently enrolled or plan to enroll: __________________________________________________ (See list of eligible certificate programs on reverse)
General Information
Award Payment and Renewal After classes start, HESAA will send half of your total annual award to your college. This payment is made after HESAA receives confirmation of your enrollment. In most cases, the college will defer payment of the amount of the award on your term bill. If your term bill does not reflect the award, contact the college. The second half of your annual award will be disbursed in the following term. The award is renewable for one year, depending on the availability of future SDA funds. To renew for a second year, you must continue to meet all eligibility requirements: 1) file a FAFSA within established State deadlines; 2) enroll at a New Jersey county college; 3) demonstrate financial need (NJEI below 10,500); 4) maintain satisfactory academic progress; and 5) complete application.
If you need additional information or help to complete this form, call 1 609 584 4480 Monday through
Thursday, 8 a.m. to 8 p.m. Friday 8 a.m. to 5 p.m., or visit our website at www.hesaa.org
Sign and date and mail completed application to: NJ HESAA, P.O. Box 540, Trenton, NJ 08625-0540 or email to
scholarsapp@hesaa.org
HESAA Only Box: Eligibility Verification Funding for Women & Minorities County College FAFSA Completed NJEI Index of 10499 or less NJ HS Diploma or GED College SAP Requirement NJ State Grant Residency Requirement