PLEASE READ BEFORE BEGINNING APPLICATION
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If you need assistance with the application, please contact:
Bernice Uresti at buresti@saafdn.org or
(210) 228-3759
Criteria for eligiblity:
Any student who lives in a county served by WellMed Medical Management who will attend
a two- or four-year accredited college, university or vocational/technical school in the
United States, and has a minimum 2.5 GPA. Financial need will be considered but is not
the sole determining factor.
Renewable for 3 years (support same student for four years) as long as eligibility criteria
is maintained which includes maintaining a 2.5 GPA and completing 12 hours pers semester.
•Texas counties include: Bexar, Kendall, Comal, Guadalupe, Wilson, Atascosa, Nueces, San
Patricio, Aransas, Jim Wells, Kleberg, El Paso, Cameron, Hidalgo, Willacy, Hays, Travis,
Williamson, Dallas, Ellis, Denton, Collin, Rockwell, Tarrant, Johnson, and Kaufman.
•Florida counties include: Polk, Pasco, Hillsborough, Pinellas, Orange, Osceola, Lake,
Seminole, Sumter, Indian River, St. Lucie, Martin, and Brevar.
PLEASE DO NOT COMPLETE ON A MAC COMPUTER - There are adobe issues.
San Antonio Area Foundation • 110 Broadway Street, Suite 230 • San Antonio, TX 78205
Rapier Educational Fund Scholarship Application
Please do not complete on a Mac computer
STEP 1: PERSONAL INFORMATION
Applicant: Mr.
Please select one... Ulysses Kevin Medrano
Title First Middle Last
Permanent
Address: 9414 Kenton Hill
Address
San Antonio TX 78240
City State Zip
Phone #: Home Phone
Please select one... (210) 979-7971 Email address: ulysseskm@yahoo.com
(###)###-####
Date of Birth: 05/02/1993 County in which you live? Bexar
Please select one...
mm/dd/yyyy
STEP 2: ACADEMIC INFORMATION
If currently in high school, please complete this section:
Name: High School International School of the Americas
Name: School District North East Independent School Di
City, State: San Antonio, Texas Year of Graduation: 2011
Please leave blank Cumulative GPA: 4
Please indicate the college, university or vocational school you plan to attend, in order of preference:
First choice: Trinity University
Second choice:
Field you plan to study: Biology
Degree you will be pursuing: Bachelors, Masters
Will you be registering as a full-time student? Yes ✔ No
If no, explain why?
If currently attending college, university or vocational school, please complete this section:
Name of School:
City, State: Cumulative GPA:
Field you are studying:
Degree you are pursuing:
Will you be registering as a full-time student? Yes No
If no, explain why?
p. 1 of 4 San Antonio Area Foundation • 110 Broadway Street, Suite 230 • San Antonio, TX 78205 • www.saafdn.org
STEP 3: INCOME INFORMATION
Parents are: Married ✔ Divorced Separated Widowed
Please complete the following information:
Father's full name: Nicolas Medrano
Email Address: nicolas.medrano@att.net Phone #: (210) 204-2378
(###)###-####
Employer Name: Labatt Food Company City, State: San Antonio, Texas
Mother's full name: Elia I. Medrano
Email Address: Phone #: (210) 204-2405
(###)###-####
Employer Name: Otto Dukes Machinery Company City, State: San Antonio, Texas
Number of dependents in family where you presently live, EXCLUDING parents, INCLUDING yourself: 2
Ages of those included above: 14, 18
Number of dependents in college, university or vocational school next year, EXCLUDING parents,
INCLUDING yourself: 1
Estimated adjusted gross income of family:
(Adjusted gross income can be found on IRS tax form 1040, 1040A or 1040EZ)
Who will be responsible for financing your college education? My parent and financial aid.
State any special personal or family circumstances affecting your need for financial assistance.
From a financial standpoint, what impact would this scholarship have on your education?
If I were to get this scholarship I would lessen even further the burden of college tuition upon my parents.
With this scholarship my education would create
Cost of attendance for first college choice: $
This can be found on the college website.
Anticipated contributions toward your college expenses: Confirmed scholarships $
Confirmed grants $
Other $
TOTAL $ 0.00
p. 2 of 4 San Antonio Area Foundation • 110 Broadway Street, Suite 230 • San Antonio, TX 78205 • www.saafdn.org
STEP 4: PERSONAL ACHIEVEMENTS
1. Describe an experience (extracurricular activity through your school or a volunteer organization) where
you demonstrated leadership or teamwork skills or learned to communicate with others.
2. Describe an achievement that you are most proud of.
3. Choose an experience from your own life and explain how it has influenced you.
STEP 5: FUTURE PLANS AND GOALS
1. Describe a community project that you are most proud of and why it was meaningful to you.
p. 3 of 4 San Antonio Area Foundation • 110 Broadway Street, Suite 230 • San Antonio, TX 78205 • www.saafdn.org
STEP 6: REVIEW AND SUBMIT YOUR APPLICATION
Note: Incomplete applications will not be considered. Additional documents, other than the
transcript and recommendation, will not be accepted.
Once you have completed and reviewed the application, you have the option to save and print a copy for your
records. You must press Submit for your application to be considered. An email will appear on your screen
with the application automatically attached. You must follow this process in order to be eligible for
consideration.
Deadline for application is Friday, May 6, 2011. Applications must be submitted electronically and
will not be accepted via mail, fax, or delivery.
Transcript must be mailed to the address below and postmarked by May 6, 2011.
If applicant in high school: official transcript must be in sealed envelope and include test scores.
If applicant in college: official transcript must include last semester and cumulative GPA.
San Antonio Area Foundation
Rapier Educational Scholarship
110 Broadway, Suite 230
San Antonio, TX 78205
One Personal Recommendation from your teacher, professor, counselor or advisor must be
submitted. Person submitting recommendation can submit directly to buresti@saafdn.org.
By typing my name below, I certify that the information on this application is true and complete to the best of my
knowledge. If asked by the San Antonio Area Foundation, I agree to provide documentation for information given
on this form. I authorize the San Antonio Area Foundation to release the information on this application to the
Scholarship Selection Committee and/or other donors.
_________________________________________________ _________________________________
Student’s Signature Date
SAVE
Save PRINT
Print SUBMIT
Submit
If you have any further questions, please contact: Bernice Uresti, Program Officer – Scholarships at
buresti@saafdn.org or by phone at (210) 228-3759. We will not accept or review incomplete applications.
p. 4 of 4 San Antonio Area Foundation • 110 Broadway Street, Suite 230 • San Antonio, TX 78205 • www.saafdn.org
