Santa Margarita Water District

Santa Margarita Water District’s Jim Mizell Memorial Water and Environmental Scholarship Program is designed for students whose educational plans or career path include water related issues, and to encourage students to pursue scientific, financial and/or environmental education in the United States.

The Jim Mizell Water and Environmental Scholarship Program will provide five successful graduating high school applicants with awards of academic assistance of $1,000 to be paid directly to an accredited junior college, college or university.

Eligibility Requirements:

• Recipient must be a citizen of the United States
• Must currently reside within the Santa Margarita Water District service area
• Cumulative GPA of 3.0 or higher (based on a 4.0 scale) in all completed courses
• Student must intend to major in a discipline related to water, engineering, biological, social or physical sciences, mathematics, finance, accounting, business administration or environmental studies

Application Components (to be submitted before deadline):

• Completed application form below
• Two references (Click here to open the reference form in a new window)
• Official high school transcript

Application Deadline:

• March 31, 2012

Completed applications (and all supporting components) should be submitted to the Santa Margarita Water District by mail to P.O. Box 7005, Mission Viejo, CA 92690-7005, Attention: Michele Miller. Applications must be received no later than March 31, 2012.

Scholarship Application

• General Information

• Full Name*
  First Name Last Name
• E-mail
• Address*

  Street Address
  Street Address Line 2
  City	State / Province
  Postal / Zip Code	Please Select United States Abkhazia Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile People's Republic of China Republic of China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Guyana Haiti Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Nagorno-Karabakh Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Turkish Republic of Northern Cyprus Northern Mariana Norway Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Transnistria Pridnestrovie Puerto Rico Qatar Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia Spain Sri Lanka Sudan Suriname Svalbard Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country

• SMWD Account Number*  
  Number can be found on your SMWD bill
• Citizenship: (Only U.S. citizens are eligible for this program). Check the box to indicate Yes.
  Yes, I am a U.S. citizen
• Academic Status Eligibility: Check the box to indicate Yes.
  Yes, I will be a freshman in a junior college, college or university in the Fall Term 2012
• High School You Attend:*
• Senior Year Weighted GPA:
• Senior Year Actual GPA:*
• School You Intend to Attend in Fall 2012:
• Personal Statement of Proposed College Education Plan and Career Goals*
  Limited to 500 words or less 0/500

• Academic Awards, Honors and Activities

• Awards/Honors:
• Extracurricular Activities:
• Paid and/or volunteer activities.

• References

• List a minimum of two people who are familiar with your academic preparation and abilities. Provide each individual a copy of the Reference Form to complete and submit on your behalf. One reference must be from an academic advisor or department head and the second from a faculty member.

  	Name:	Title and Organization:	E-mail Address:
  1*
  2*
  3

• Before submitting your application make sure you print two copies of the reference form, first one filled out by an academic advisor or department head and one by a faculty member.

• Check the following boxes to answer Yes*
  I will print two reference forms and have them filled out by the appropriate parties I will have an official transcript sent to the address provided
• Submit Form
• Should be Empty: