ILLINOIS STATE UNIVERSITY



ILLINOIS STATE UNIVERSITYDepartment of PsychologyWalter Vernon Scholarship in PsychologyApplication Deadline: April 1Type in the required information in the boxes, which will expand as needed. Email electronic copies of the completed application and other required materials to the Awards Committee Chair at jeffreywagman@illinoisstate.edu.Name FORMTEXT ?????Date FORMTEXT ?????Local Street Address FORMTEXT ?????City, State, Zip Code FORMTEXT ?????University ID FORMTEXT ?????Phone FORMTEXT ?????Colleges or Universities AttendedAttendance DatesSchool:From (MM/YY)Until (MM/YY) FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Required CoursesCourses:InstructorSemester/YearGrade FORMCHECKBOX PSY 110 Fundamentals of Psychology FORMTEXT ????? FORMTEXT ?????Aor (select one) FORMCHECKBOX PSY 111 Introduction to Psychology FORMTEXT ????? FORMTEXT ?????AEnglish course: FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????ACumulative GPA FORMTEXT ?????Last semester GPA FORMTEXT ?????Psychology GPA FORMTEXT ????? based on FORMTEXT ????? hours.Provide a brief statement about why you believe the Department of Psychology should award you the Walter Vernon Scholarship in Psychology. FORMTEXT ?????? I certify that the information on this application is factual and true to accurate to the best of my knowledge.Date: FORMTEXT ????? The following documents should be submitted to the department’s Awards Committee:A completed application;A current Academic Progress Summary; andTwo (2) letters of recommendation, for which one letter must be from the faculty member who taught the psychology course at Illinois State.Revised: August 2019 ................
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