David Morgan Kiekel Memorial - College of Liberal Arts



Tom & Pat Gallagher

Scholarship Application

2015-16

Application Packets MUST be received at Gilkey Hall 213 before 5:00 p.m. on

Friday, March 20, 2015

Personal Information

Name: __________________________________________________________________

(Last Name) (First Name) (Middle)

OSU ID Number: ____________________

Major: ______________________________ Minor (if any): _______________________

First Term at OSU: ______ / ______

Term Year

Total Completed Credits: _______ as of ______ / ______

Term Year

Anticipated Date of Graduation: ______ / ______ OSU GPA: ______

Term Year

Contact Information

Local Address: _________________________________________________________________

_________________________________________________________________

Local Telephone No: ____-______-______

Permanent Address: _____________________________________________________________

_____________________________________________________________

Permanent Telephone No____-______-______ Legal State of Residence: ______

High School Name and Hometown: _________________________________________________

Tom & Pat Gallagher Scholarship ($1000)

This scholarship was funded with the generous donations of Thomas L. Gallagher, Jr., and Patricia A. Gallagher. Graduates of Oregon State University, the Gallaghers believe in the value of a liberal arts education and are committed to encouraging students in pursuing liberal arts educations.

Criteria:

• Student must be enrolled as undergraduate, sophomore or higher standing, majoring in the College of Liberal Arts

• Must be in good academic standing and have a 3.25 GPA or higher

• Student must have graduated from an Oregon public high school

• Financial need will be considered in the decision process

A complete application packet includes:

1. Tom & Pat Gallagher Scholarship Application.

2. A two (2) page essay describing why you are pursuing a liberal arts education.

3. A completed financial worksheet (included).

4. ***Two (2) letters of reference and reference forms (included in this packet) from OSU faculty and/or classroom teachers who can attest to your outstanding academic performance. NOTE: No letters/references from family members, please.

☼ ☼ ☼ ☼ ☼ ☼ ☼ ☼ ☼ ☼ ☼ ☼

Incomplete applications will not be considered

All letters and forms must be received by 5:00 P.M. on

Friday, March 20, 2015. You may mail, fax, or email your documents

Tom & Pat Gallagher Scholarship Committee

OSU, College of Liberal Arts

Gilkey Hall 213

Corvallis, OR 97331

Fax: 541-737-2434

E-mail: liberalarts@oregonstate.edu

Please direct any questions to the College of Liberal Arts Student Services Office at 737-0561.

College of Liberal Arts Scholarship

Financial Worksheet

Financial Information

Will you receive OSU financial aid for the 2015-16 academic year?

Yes _____

No _____

Please list the (approximate) amount of awards you will receive for the 2015-16 academic year:

Scholarships/Grants _____

Loans _____

Please list other financial resources for the 2015-16 academic year:

Family/jobs/savings _____

Other _____

Total estimated financial resources:_____

Expected Costs for the 2015-16 academic year

Tuition/Fees _____

Room/Board _____

Transportation _____

Health Insurance _____

Travel _____

Books/Supplies _____

Clothing/Personal _____

Estimated Total Costs: _____

College of Liberal Arts Scholarship Reference Form

Page 1

Student’s Name:

The student named above has applied for the Tom & Pat Gallagher Scholarship. This scholarship was funded with the generous donations of Thomas L. Gallagher, Jr., and Patricia A. Gallagher.

Criteria:

• Student must be enrolled as undergraduate, sophomore or higher standing, majoring in the College of Liberal Arts

• Must be in good academic standing and have a 3.25 GPA or higher

• Student must have graduated from an Oregon public high school

• Financial need will be considered in the decision process

A complete reference includes this 2-page form AND a detailed letter.

Application Deadline: Friday, March 20, 2015 by 5:00PM

Note: You may submit your reference and letter via email, fax, or deliver it to the address below. Applications will not be processed unless the selection committee receives both documents.

Tom & Pat Gallagher Scholarship Committee

OSU, College of Liberal Arts

Gilkey Hall 213

Corvallis, OR 97331

Fax: 541-737-2434

E-mail: liberalarts@oregonstate.edu

College of Liberal Arts Scholarship Reference Form

Gallagher, Page 2

Student’s Name:

Please rate the applicant on the factors listed below:

| |Fair |Average |Good |Excellent |Outstanding |Not Observed |

|Interpersonal Skills | | | | | | |

|Academic Skills and Knowledge | | | | | | |

|Motivation and Perseverance | | | | | | |

|Communication Skills | | | | | | |

|Responsibility and Self-direction | | | | | | |

|Contribution to Community | | | | | | |

|Ability to Work with Groups | | | | | | |

|Attitude | | | | | | |

Your Contact information:

Print Name Date

Title/Position Institution/Business

Address and Phone

Signature

College of Liberal Arts Scholarship Reference Form

Page 1

Student’s Name:

The student named above has applied for the Tom & Pat Gallagher Scholarship. This scholarship was funded with the generous donations of Thomas L. Gallagher, Jr., and Patricia A. Gallagher.

Criteria:

• Student must be enrolled as undergraduate, sophomore or higher standing, majoring in the College of Liberal Arts

• Must be in good academic standing and have a 3.25 GPA or higher

• Student must have graduated from an Oregon public high school

• Financial need will be considered in the decision process

A complete reference includes this 2-page form AND a detailed letter.

Application Deadline: Friday, March 20, 2015 by 5:00PM

Note: You may submit your reference and letter via email, fax, or deliver it to the address below. Applications will not be processed unless the selection committee receives both documents.

Tom & Pat Gallagher Scholarship Committee

OSU, College of Liberal Arts

Gilkey Hall 213

Corvallis, OR 97331

Fax: 541-737-2434

E-mail: liberalarts@oregonstate.edu

College of Liberal Arts Scholarship Reference Form

Gallagher, Page 2

Student’s Name:

Please rate the applicant on the factors listed below:

| |Fair |Average |Good |Excellent |Outstanding |Not Observed |

|Interpersonal Skills | | | | | | |

|Academic Skills and Knowledge | | | | | | |

|Motivation and Perseverance | | | | | | |

|Communication Skills | | | | | | |

|Responsibility and Self-direction | | | | | | |

|Contribution to Community | | | | | | |

|Ability to Work with Groups | | | | | | |

|Attitude | | | | | | |

Your Contact information:

Print Name Date

Title/Position Institution/Business

Address and Phone

Signature

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