NextUp/Guardian Scholars Application Personal InformationName(Required) First Middle Last Preferred Pronouns(Required)Select…He/HimShe/HerThey/ThemPrefer Not to SayRHC Student ID#Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Cell PhoneOther PhoneDate of Birth(Required) Age(Required)AccessRio E-mail Your Rio Hondo College email address is your first name . your last name and the last four digits of your Rio Hondo College ID number. For example, [email protected]Personal E-mail(Required) Foster Care Eligible StudentsPlacement (Check all that apply)(Required) Foster Care KIN GAP (Kinship Relative Care) SILP (Supervised Independent Living Placement) STRTP (formerly known as group home) Transitional Housing Probation Which County Are/Were You in Care?(Required) Los Angeles Orange Riverside San Bernardino San Diego Other Foster Care Verification LetterPlease upload Foster Care Verification Letter *If unable to obtain please contact our office for assistance (562) 908-3435. Drop files here or Select files Accepted file types: jpg, png, pdf, Max. file size: 5 MB, Max. files: 2. I certify that the information on the application is complete and correct to the best of my knowledge. I grant the Rio Hondo Guardian Scholars office the authority to verify and/or obtain the records necessary to document the above information as well as to receive information regarding my college and academic status from other college departments. I am aware that any false statement or any withholding information regarding the Guardian Scholars program criteria may result in the disqualification of my application for Guardian Scholars services and grants.Full Name(Required)Signature(Required)Date(Required)
