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1. Candidate
Date:
Name:
Address:
Phone:
Email:
2. Educational Status of Candidate
University/College:
Status:
Undergraduate Year:
Masters Year :
Major:
Minor:
Thesis or Project:
Expected Graduation/Completion Date:
GPA Undergraduate:
GPA Postgraduate:
Student ID No.:
Social Security No.:
3. Describe current goals and specify details concerning university enrollment, graduate studies, etc. for the academic year in which the scholarship is requested.
4. Amount of scholarship requested:
5. Why is the scholarship requested and how will it be used, if granted?
6. Extracurricular activities, interests, campus or part-time employment:
7. Faculty and scholastic references:
At least two letters of recommendation must either be attached to this application or send directly to the Scholarship Committee. These letters must stipulate specific plans for the academic year in which the scholarship is received.
8. Provide the name and address of the division of your university’s scholarship program to which the scholarship check should be sent if you are selected.
As part of your application process, please contact your Financial Aid office to determine how this scholarship might impact your financial aid package, such as grants, loans and other scholarships, should you receive this scholarship.
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