Bay Area Underserved Law Student Scholarship Program

1. PERSONAL INFORMATION

Please note: All information provided will be kept confidential and may be subject to verification. Please provide information in all designated areas, unless otherwise noted, to facilitate review by the selection committee and to ensure your application is complete. If answer is “none” or “not applicable,” please indicate as such.

Name*

First Last

Date of Birth*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email*

Phone*

College*

I have been admitted to (check all that apply):*

UC Berkeley
UC College of the Law, San Francisco
University of San Francisco
Santa Clara
Stanford

I have accepted admission to a San Francisco Bay Area Law School.*

Name of school	I notified the school on:

LSAT score*

Final LSAT score	Date exam taken

Schools Attended*

From	To	Name, City and State of School Attended	Major	Degree awarded	GPA

Work Experience*

From	To	Name, City and State of Employer	Position Held

List your work experience, including part-time and/or summer positions, present employer first. (In addition, you may attach a current copy of your résumé, but this section below must also be completed).

College Organization Activities*

Organization	Years Involved/amount of time each year	Roles and Responsibilities (one sentence max.)

Attach an additional sheet using same format, if necessary.

Non-College Community Service Activities*

Organization	Years Involved/amount of time each year	Offices Held and Duration of Tenure

During the last five years. Attach an additional sheet using same format, if necessary.

Honors or Awards received*

Honor/Award Name	Year Received	Description of Honor/Award (one sentence max.)

Attach an additional sheet using same format, if necessary.

Are you the first person in your immediate family to have attended college?*

yes
no

Are you the first person in your immediate family to have graduated from college?*

yes
no

Are you the first person in your immediate family to attend graduate school?*

yes
no

Have you participated in any of JDC’s Destination Law School events/programs?*

yes
no

Professional References*

Name	Relationship	Email	Phone

Please list three personal references. (Please do not list relatives)

2. FINANCIAL INFORMATION & FINANCIAL EDUCATION HISTORY

Please list the following information:*

Upcoming loans in repayment amount	Current student loan debt amount	Other financial aid or assistance received/anticipated

GRANTS AND SCHOLARSHIPS (Undergraduate and/or graduate school other than law school)

Grant/Scholarship Name	Total Amount Awarded	Yearly Amount	Academic Year Received

Please list current and all undergraduate/graduate grants/scholarships here

LOANS (Undergraduate and/or graduate school other than law school)*

Name of Loan	Total Amount	Yearly Amount	Academic Year Received

Please list current and all undergraduate/graduate loans here

GRANTS AND SCHOLARSHIPS (Law School)*

Grant/Scholarship Name	Total Amount Awarded	Yearly Amount	Duration of Award: Ex. Yearly

Please list grants and scholarships promised and applied for, for the next academic law school year. Please add attachments as needed.

LOANS (Law School)*

Loan	Total Amount	Yearly Amount	Duration of Loan

Please list grants and scholarships promised and applied for, for the next academic law school year. Please add attachments as needed.

APPLICANT FINANCIAL STATUS

A) Do you receive veteran benefits or income?*

yes
no

B) Are you married?*

yes
no

C) Are you separated?*

yes
no

D) Do you have any legal dependents?*

yes
no

E) Did you file a 1040/1040A/1040EZ IRS tax form last year?*

yes
no

Please include last year’s tax form(s) with this application and complete all the sections below that are applicable to you. If you did not and will not file a 1040/1040A/1040EZ IRS tax form last year, please complete all the sections below that are applicable to you.

F) Did your parent(s)/guardian(s) file a 1040/1040A/1040EZ IRS tax form last year?*

yes
no

If you answered “No” to questions A, B and C above, please include your parent(s)/guardian(s) tax forms from last year with this application and complete all the sections below that are applicable to you and your parent(s)/guardian(s). If your parent(s)/guardian(s) did not, and will not file a 1040/1040A/1040EZ IRS tax form, please complete all sections below that are applicable to you and your parent(s)/guardian(s).

APPLICANT’S 2024 FINANCIAL CONDITION

(Add spouse, if applicable)

Current hourly wage and/or salary amount*

Applicant	Spouse (if applicable)

Total expected income for this year*

Applicant	Spouse (if applicable)

Months expected to work*

Applicant	Spouse (if applicable)

Checking account balances*

Applicant	Spouse (if applicable)

Money market balances, stocks, bonds, CDs or other investments*

Applicant	Spouse (if applicable)

Savings account balances*

Applicant	Spouse (if applicable)

Monthly rent payment*

Applicant	Spouse (if applicable)

Do you own a home, or other real estate?*

Yes
No

If yes, current value?

Current mortgage balance*

Applicant	Spouse (if applicable)

Monthly mortgage payment*

Applicant	Spouse (if applicable)

Do you own a business (either in part or in full)?*

Yes
No

If yes, please describe:

Trust funds received or to be received*

Applicant	Spouse (if applicable)

Retirement account balances*

Applicant	Spouse (if applicable)

INCOME

INCOME [REFER TO YOUR IRS TAX FORM(S) WHERE APPLICABLE]

IRS Tax Form Filed

1040, total income, line 22*

Single by Applicant	Single by Spouse	Jointly

1040EZ, adjusted gross income, line 4*

Single by Applicant	Single by Spouse	Jointly

1040A, total income, line 15*

Single by Applicant	Single by Spouse	Jointly

If you did not and will not file an IRS tax form(s) last year, please fill out the following:

Last year’s earned income

Applicant	Spouse

Last year’s untaxed income

Applicant	Spouse

Last year’s interest/dividend income

Applicant	Spouse

UNTAXED INCOME AND BENEFITS

Social Security benefits*

Single by Applicant	Single by Spouse

Temporary Assistance for Needy Families (TANF)*

Single by Applicant	Single by Spouse

Aid to Families with Dependent Children*

Single by Applicant	Single by Spouse

Child support received*

Single by Applicant	Single by Spouse

Other public assistance*

Single by Applicant	Single by Spouse

Other income**

Single by Applicant	Single by Spouse

*Please explain other income:

DEPENDENTS/DEPENDENT CARE

Refer to your IRS tax form(s) where applicable

IRS Tax Form Filed

1040 or 1040A, line 6d*

Single by Applicant	Single by Spouse	Jointly

1040 or 1040A, form 2441, part II, line 3*

Single by Applicant	Single by Spouse	Jointly

The number of dependents you and your spouse (if applicable) have?*

INCOME FROM ASSETS

IRS Tax Form Filed

1040 or 1040A:

Taxable interest income, line 8a*

Single by Applicant	Single by Spouse	Jointly

Tax exempt interest, line 8b*

Single by Applicant	Single by Spouse	Jointly

Dividends, line 9*

Single by Applicant	Single by Spouse	Jointly

1040 EZ:

Taxable interest income, line 2*

Single by Applicant	Single by Spouse	Jointly

FINANCIAL CONDITION OF PARENT(S)/GUARDIAN(S)

(Either or both parents/guardians as applicable)

Will you be receiving any financial assistance from your parent(s)/guardian(s) for this academic year?*

Yes
No

If yes, please list the anticipated amount:

Checking/money market account balances:

Savings account balances:

Parent(s’)/Guardian(s’) occupations:

Do your parent(s)/guardian(s) own a home or real estate?

Yes
No

If yes, current value:

Current mortgage balance:

Monthly mortgage payment:

YOUR PARENT(S)/GUARDIAN(S) INCOME

(Refer to IRS Tax Form(s) as applicable)

IRS Tax Form Filed

1040, adjusted gross income, line 37

Parent #1	Parent #2	Jointly

1040EZ, adjusted income, line 4

Parent #1	Parent #2	Jointly

1040A, adjusted gross income, line 21

Parent #1	Parent #2	Jointly

If your parent(s)/guardian(s) did not and will not file a IRS tax form, please fill out the following:

Last year’s earned income

Parent #1	Parent #2

Last year’s untaxed income

Parent #1	Parent #2

Last year’s interest/dividend income

Parent #1	Parent #2

Other income*

Parent #1	Parent #2

*Please explain other income:

YOUR PARENT(S)/GUARDIAN(S) EXEMPTIONS

(Refer to your parent(s)/guardian(s) IRS tax form(s) from last year as applicable.)

Last year’s IRS Tax Form Filed

1040, line 6d

Parent #1	Parent #2	Jointly

1040A, line 6d

Parent #1	Parent #2	Jointly

If your parent(s)/guardian(s) did not and will not file an IRS tax form(s) last year, how many exemptions would they have claimed had they filed?

Your Parent(s)/Guardian(s) Untaxed Income and Benefits

Social Security benefits

Parent #1	Parent #2

Aid to Families with Dependent Children (AFDC)

Parent #1	Parent #2

Child support received

Parent #1	Parent #2

Other public assistance

Parent #1	Parent #2

Other income*

Parent #1	Parent #2

*Please explain other income:

REQUIREMENTS FOR YOUR APPLICATION TO BE REVIEWED

Please upload the following documents to this completed application. Your application will be incomplete and will not be considered if any of the following documents are not included.

Official transcript(s)

Drop files here or

Max. file size: 50 MB.

Official transcript(s) from all undergraduate and graduate schools (if applicable). No copies will be accepted. Transcripts must be sent directly to JDCLawStudentScholarship@sfbar.org.

A personal statement, up to 500 words

Max. file size: 50 MB.

A personal statement, up to 500 words, stating obstacles, adversity, or disadvantages you have overcome in pursuing your education and what qualities and talents you would bring to the legal profession. Please note: Due to the number of applications we receive, the review committee will not read statements beyond the 500 word limit.

Statement of economic need (not to exceed 250 words)

Max. file size: 50 MB.

Statement of economic need (not to exceed 250 words) stating your or your parents’/guardians’ current financial situation and/ or your financial need.

Copies of last year’s IRS tax form(s) if you did or will file IRS tax forms

Max. file size: 50 MB.

Copies of last year’s IRS tax form(s) if you did or will file IRS tax forms.

A copy of a letter or letters of admission from any of the San Francisco Bay Area Law Schools

Max. file size: 50 MB.

A copy of a letter or letters of admission from any of the San Francisco Bay Area Law Schools listed above.

A copy of your current resume.

Max. file size: 50 MB.

Note: No other material, besides the above items, will be reviewed by the selection committee.

Application Packet Submission

I declare under the penalty of perjury that the information I have provided is true and correct to the best of my knowledge.

Name*

First Last

Date*

Scholarship recipients will be notified by end of July and invited to a reception.