DEPARTMENT OF COMPUTER SCIENCE
SCHOLARSHIP APPLICATION
RETURNING COMPUTER SCIENCE STUDENTS
Name
MSU Student ID: ______________________
Last
First
Middle
Address______________________________________________
Telephone No. (
)
City_____________________________ State__________________ Zip ________________
Email: ________________________________________________________
Full-Time:
Yes
No
Current Overall GPA: _____
(Must be greater than or equal to 3.0)
CMPS GPA: ______
(Must be greater than or equal to 3.0)
Classification: ____________________
(Freshman, Sophomore, Junior or Senior)
Earned Hours: _______
ACM Member: Y___ N ___
ACADEMIC BACKGROUND
(List computer science, science and math courses taken in last 2 semesters--fall/spring)
Course Title
Year Taken
Grade
COMMENTS
(List additional information which you feel supports your application)
Signature
Date
Complete form and print it. Mail or hand carry to MSU, Computer Science Dept., 3410 Taft Blvd., BO #126, Wichita Falls, TX 76308.
APPLICATION DEADLINE: March 3rd
All filed submissions will be reconsidered for a period of one year
Return to: Scholarship Coordinator, Computer Science Department, Midwestern State University, 3410 Taft Boulevard, Wichita Falls, TX 76308
F:CMPS/Undergrad Scholarship/Returning Student Scholarship Appl 011014
Updated 01/10/14
Student’s Relationship to MSU’s Board of Regents Members
State law requires that each student identify any relation to a current Board of Regent member. A student who is
related to a current member of the governing board of that institution is prohibited from receiving scholarships
unless the scholarship is awarded exclusively based on academic merit or is an athletic scholarship. It is a Class B
misdemeanor to file a false statement.
Please review a list of current Midwestern State University Board of Regent members at
http://welcome.mwsu.edu/president/regents.asp and then select the most appropriate answer below indicating
your relation to any of the Board of Regent members.
___Not Related to a Regent
___Regent's mother, father, daughter or son
___Regent's brother, sister, grandparent or grandchild
___Regent's great-grandchild, uncle (brother of parent), aunt (sister of parent), nephew (son of brother or sister),
or niece (daughter of brother or sister)
___Regent's spouse; spouse's child's spouse's mother or father; child's spouse; or parent's spouse
___Regent's spouse's brother or sister; spouse's grandparent; spouse's grandchild; brother or sister's spouse;
grandparent's spouse; or grandchild's spouse
Student’s name (printed) ______________________________________________
Student’s signature___________________________________________________
Date _______________________________
F:CMPS/Undergrad Scholarship/Returning Student Scholarship Appl 011014
Updated 01/10/14