Alumni.umich.edu
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INSTRUCTIONS
PLEASE SUBMIT ALL OF THE FOLLOWING:
o This completed application form including an essay and any attached additional pages
o Your high school transcript including the most recent Fall semester grades
o TWO letters of recommendation from teachers, a counselor or mentor.
Mail to: University of Michigan Club of Greater Northville
P.O. Box 453, Northville, MI 48167
Applications are accepted from high school seniors admitted to one of the three U of M campuses (Ann Arbor, Dearborn, Flint) and who live in the club’s geographic area which includes the following ZIP Codes: 48150, 48152, 48154, 48165, 48167, 48168, 48170, 48175, 48185, 48186, 48187, 48188, 48331, 48334, 48335, 48336 48356, 48357, 48374, 48375, 48377, 48380, 48381, 48382, 48383, 48386, 48390, 48391, 48393. These ZIP Codes cover the communities of Canton, Commerce Township, Farmington, Farmington Hills, Highland, Livonia, Milford, New Hudson, Northville, Novi, Plymouth, Salem, Walled Lake, Westland, White Lake and Wixom.
Applications must be received by April 17, 2020 and cannot be considered if late or incomplete.
Direct all questions to Club Scholarship Chair Colleen Williams at colwil2@.
BIOGRAPHICAL DATA
Name ___________________________________________ DOB: ____/_____/_____
Last, First, M.I. Mon Day Yr
Address: __________________________________________ Phone (______) ______________
Street
__________________________________________ E-mail: _____________________
City State Zip
High School _______________________________________ Graduation Date ______________
ACT __________ Class Rank ________ Of _______
And / or
SAT ___________ (Math _______, Verbal_______) GPA _________
NAME ___________________________
ADMISSION STATUS
U of M Admission Status: Applied _______ Admitted ________
Yes / No Yes / No
If admitted, have you accepted the offer of admission to the U of M ? _______
Yes / No
If no, please explain why you have not accepted admission _______________________
Which U of M School or college will you attend? _________________________________________
Field of study __ ___________________________________________________________________
AP / HONORS / COLLEGE COURSES
____________________________ 9 10 11 12 ____________________________ 9 10 11 12
____________________________ 9 10 11 12 ____________________________ 9 10 11 12
____________________________ 9 10 11 12 ____________________________ 9 10 11 12
____________________________ 9 10 11 12 ____________________________ 9 10 11 12
SCHOOL ACTIVITIES
ACTIVITY GRADE(S) - CIRCLE LEADERSHIP ROLE OR AWARDS
__________________________________________ 9 10 11 12 ____________________________________
__________________________________________ 9 10 11 12 ____________________________________
__________________________________________ 9 10 11 12 ____________________________________
__________________________________________ 9 10 11 12 ____________________________________
__________________________________________ 9 10 11 12 ____________________________________
ATHLETIC PARTICIPATION
__________________________________________ 9 10 11 12 ____________________________________
__________________________________________ 9 10 11 12 ____________________________________
__________________________________________ 9 10 11 12 ____________________________________
__________________________________________ 9 10 11 12 ____________________________________
COMMUNITY ACTIVITIES
__________________________________________ 9 10 11 12 ____________________________________
__________________________________________ 9 10 11 12 ____________________________________
__________________________________________ 9 10 11 12 ____________________________________
__________________________________________ 9 10 11 12 ____________________________________
WORK EXPERIENCE
__________________________________________ 9 10 11 12 ____________________________________
__________________________________________ 9 10 11 12 ____________________________________
__________________________________________ 9 10 11 12 ____________________________________
__________________________________________ 9 10 11 12 ____________________________________
NAME ___________________________
RECOGNITION – HONORS –AWARDS – VOLUNTEER ACTIVITES (NOT PREVIOUSLY MENTIONED)
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________
APPLICATION ESSAY (REQUIRED)
Please use this page to present an essay up to 250 words to give any information which you believe may help the committee evaluate your application. Some essay ideas might be: What are your goals? What is your chief personal strength? Is there a person or event that has influenced you in a significant way?
- You may use a separate page and attach it.
Understanding that incorrect or misleading information would be grounds for revocation of an award, I attest that the information above and on all attached documents is correct and submit this application for consideration.
________________________________________ ________________________
Applicant’s Signature Date
-----------------------
U OF M ALUMNI CLUB OF GREATER NORTHVILLE
SERVING WEST METRO DETROIT
2020 SCHOLARSHIP APPLICATION
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