Center for Excellence in Education - NAU



Graduate College Scholarship ApplicationGraduate College/Graduate Student Government and Louis H. & Betty J. Quayle ScholarshipsNote: This is a fillable Word form, which can be filled out and saved as a .pdf for submission.Name: FORMTEXT ?????This application form is for scholarships awarded through the Graduate College and the Graduate Student Government and can only be used for students admitted into a graduate-level degree program at NAU. Please indicate “yes” or “no” to the following items: FORMTEXT ?????Have you been admitted to NAU as a degree-seeking graduate student for 2017-18?**Full- and part-time students are eligible FORMTEXT ?????Are you a Graduate Assistant for 2017-18?If so, how many hours per week? FORMCHECKBOX 10 or FORMCHECKBOX 20 FORMTEXT ?????Is a current FAFSA application on file for 2017 (if you are a US resident)? FORMTEXT ?????Are you receiving funding from other sources for 2017-18?Complete Graduate College scholarship CHECKLIST above and APPLICATION FORM below, sign, and date.Please attach a statement that between one and two pages in length. In this statement, we want to see holistic picture of you and your academic journey to date. Your statement will include, but is not limited to, the following information:Why you are pursuing a graduate degree in your discipline;The relationship between your degree and your career goals and aspirations;Compelling personal story related to your academic pursuit;Why you are applying for this scholarship.APPLICATION DEADLINE: March 1, 2017Send this scholarship application form and statement as one PDF attachment via e-mail to:GradAwards@nau.eduFor additional information or questions, please send an email to: GradAwards@nau.eduGraduate College and Graduate Student Government Scholarship Application 2017-18Note: This is a fillable word form, which can be typed into and saved as a .pdf to submit.Name: FORMTEXT ?????NAU ID: FORMTEXT ?????Academic Plan: FORMTEXT ?????Email: FORMTEXT ?????@nau.eduAddress: FORMTEXT ????? FORMTEXT ?????Phone: FORMTEXT ?????Are you a member of a federally recognized Native American nation or tribe? FORMCHECKBOX Yes FORMCHECKBOX NoIf “Yes” please list your nation or tribe*: FORMTEXT ?????*If applying for the Louis H. and Betty J. Quayle Scholarship, you will need to provide a copy of your tribal enrollment document (e.g. Certificate of Indian Blood, enrollment card) along with this application.Collegiate Educational Background: (please include NAU graduate study or planned study)College/UniversityCollege/UniversityCollege/UniversityName: FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Location: FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Dates Attended: FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Major: FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Degree: FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Date of Degree: FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Final GPA: FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Scholarships & Financial Aid Awards: (List all sources and amounts you have applied for or know you will receive for 2017-18) FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Additional Information:Past Honors and Awards: FORMTEXT ?????Current or Past Significant Research, Scholarship, or Creative Activities related to degree or field: FORMTEXT ?????Current and Past Extracurricular Activities, including community service and volunteer activitie:? FORMTEXT ?????Supplemental Information: To give your scholarship application full consideration, answer the following questions. If you indicate a yes response to questions 1-3, please provide an additional sheet with details on your response.Are you a returning student? (started your graduate education, left school, and are now returning) FORMCHECKBOX Yes FORMCHECKBOX NoAre you eligible for tuition benefits through employment, or as a dependent, domestic partner, or a spouse of an employee at a state university in Arizona? FORMCHECKBOX Yes FORMCHECKBOX NoAre you considered an Arizona resident? FORMCHECKBOX Yes FORMCHECKBOX NoProfessional or Academic References: NameTelephoneE-mail FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????I confirm by my signature and/or printed and/or typed name below that the information I have provided on this application is accurate and true to the best of my knowledge. I understand that the scholarship is awarded at the discretion of the Graduate College, and I give Graduate College staff permission to contact my school(s) or other references for verification of this information. I also understand that by asking to be considered for a Graduate College scholarship, I am giving consent for NAU to release appropriate personal information to donors or within press releases or feature articles. This includes, but is not limited to, my application information (resume, essay, etc.), year in school, major, etc. No FERPA protected information will be released. FORMTEXT ????? FORMTEXT ?????Signature/Printed/Typed NameDate ................
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