Japanese American Religious and Cultural Center (JARCC)

3165 Treat Blvd., Concord, CA 94518

College Scholarship Application Form

PART I

Name___________________________________________________________________

Address_________________________________________________________________

Signature of Applicant_____________________________________________________

Signature of Parent________________________________________________________

PART II

Community College or High School__________________________________________

*Please complete the following in essay form:

1. Extracurricular and Community:

a. Description of participation in extracurricular activities (organizations, honor societies, music activities, student government, student body activities, athletics, honors, etc.)

b. Description of participation in community activities (service groups, church activities, Scouts, clubs, volunteer activities, etc.)

2. Japanese American (JA) Club activities (Description of participation in Diablo JA Club activities. Applicant must be an active and current member of the J.A. Club a minimum of the last 3 years)

3. Junior College or 4-year University_________________________________________

4. Attach:

Two or more Letters of Recommendations, including one letter from a JA

member who can write about your involvement in the JA Club

Copy of Transcript

SAT or ACT scores

Any Additional Information

Deadline: May 18, 2009 Return to: Karen Sakata, Scholarship Chairman

Phone or Email a request for street address

Home Phone (925)837-9216

Ksa20@comast.net

*Judging is based only on the information provided.