2020-2021 HAL Scholarship Application - Greater Austin Hispanic Chamber of Commerce (GAHCC):

First Name *

Last Name *

Phone Number *

Email *

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Scholarship Assistance Request

I have (check all that apply): *

Discussed with my employer Have not yet discussed with my employer Determined what I can contribute personally Not yet determined what I can contribute personally

After estimating the financial support from my employer and my personal commitment, I may need a partial scholarship in the amount of: *

Brief explanation describing the need for the requested scholarship *

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Commitment Statement and Signature

I understand that should I be selected into HAL, my request will be reviewed and I will be asked to negotiate terms of an agreement with the GAHCC. The completed section below will serve as my electronic signature.

Date *

Format: MM/dd/yyyy

Intials *