City of Milpitas Youth Scholarship Program - NJROTC Higher Education (Graduating Senior)

The City of Milpitas believes that helping students achieve their goals is important to the wellbeing of its youth and to the overall enrichment of the community. The purpose of the Youth Scholarship Program is to allow low-income Milpitas resident youth to submit a request for funding assistance for academic improvement, community service, participation in the Naval Junior Reserve Officer Training Corps (NJROTC), and participation in youth sports.

In addition to a timely and complete application, the Youth Scholarship applicant must demonstrate the following:
1. Applicant must reside in Milpitas and be enrolled in a Milpitas School;
2. Applicant household income must qualify for the City of Milpitas, Milpitas Assistance Program (MAP); and
3. Applicant must meet eligibility requirements for each funding area(s) they submit application for.

Additional criteria for Scholarship Funding Area listed below.

Youth Applicant Name Youth Applicant Name First Last
Youth Applicant Birthdate Youth Applicant Birthdate / MM / DD YYYY
Parent/Guardian Name Parent/Guardian Name First Last
Parent/Guardian Relationship to Applicant (if guardian, must have proof of legal custody)
Address of Residence Address of Residence
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Phone - ### - ### ####
Email
Name of Currently Enrolled School
Proof of Residency and Milpitas School Enrollment (all below required)
• Valid Driver’s License (parent and/or legal guardian)
• Proof of enrollment in a Milpitas School for the current school year (copy of current school ID, Aeries Portal, Parent Square, or similar)
• Statement showing Parent or legal guardian’s name and Milpitas address. Acceptable forms of mail include Bank, Credit Card, Insurance (sensitive information should be redacted)

Attach Files
Household Income Qualification
Applicant Household must be low or very low income to qualify for this scholarship program. Proof of household income can be provided through one (1) of the following documents:
• Milpitas Assistance Program (MAP) enrollment letter (current year)
• Proof of enrollment in PG&E Cares Program
• Proof of enrollment in Free or Reduced Lunch Program at MUSD
• Household Income Tax Information (last year's taxes showing household total income - Attach the first two pages of your Form 1040 - please redact SSN's)

Attach Files
NJROTC Scholarship Eligibility Criteria:
1. For graduating seniors, applicant:
1.2 Applicant must be accepted to a higher education school and have a support letter from their NJROTC advisor confirming their enrollment and active participation in the Milpitas High School NJROTC Program for at least two (2) years, including their senior year.
1.3 Applicant can request funds to assist with Higher Education Tuition and/or Education Materials (i.e., books, laptops)

This is the description of your section break.
Graduating Senior Funding Request (Click all that apply. Must include next year school information. Total funding request cannot exceed $500.)
I am requesting funds for:

Graduating Senior Funding Request (Click all that apply. Must include next year school information. Total funding request cannot exceed $500.)
I am requesting funds for: Education Materials (i.e. Lap top, books) Higher Education Tuition Costs (i.e. vocational, Jr. College, College) Name of School Enrolled in for the 2023-24 School Year
Requested Scholarship Amount - Tuition (if you are not requesting funds for this area, put 0)
Requested Scholarship Amount - Education Materials (if you are not requesting funds for this areas, put 0)
List of Tuition and Education Materials and their estimated costs (Total cannot exceed $500)
Upload support letter from their NJROTC advisor confirming their enrollment and active participation in the Milpitas High School NJROTC Program for at least two (2) years, including their senior year.

Attach Files
Upload Higher Education Acceptance Letter

Attach Files
I have read and understand the City of Milpitas Youth Scholarship Program Policy and understand my responsibilities as an applicant should I receive a scholarship. I certify that the information provided on the application is correct to the best of my knowledge. I further understand that falsification of information will automatically disqualify the applicant from receiving this or any other scholarship from the City of Milpitas.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.