Please email this application to Michael
Murphy at michael.murphy@ttu.edu by
February 17th, 2016 at 5:00pm.
______________________________________________________________________________________________
Good Neighbor Scholarship Application
2016 - 2017
Personal Information
Last (Family) Name:
First (Given) Name:
Student ID Number (R Number):
Local Mailing Address
City
State
Zip Code
Phone Number (Including Area Code):
E-mail Address:
First Semester at TTU: Semester/Year
Major/Program of Study:
Expected Date of Graduation: Semester/Year
Cumulative GPA:
Financial Information
Are you currently employed?
If yes, what are your monthly wages?
Employer:
Position:
Do you, or will you receive, a waiver of non-resident waiver as a benefit of on-campus employment?
Yes
No
If yes, will this be in effect during the semester(s) for which you are applying (Fall, Spring, Summer I
and Summer II of the following academic year)?
Yes
No
Do you receive a waiver of non-resident tuition as a benefit of a scholarship?
Yes
No
If yes, list name and source of scholarship?
List all financial assistance/scholarship for which you have applied.
Eligibility Information
Country of Birth:
How long did you live in your Country of Birth?
Country of Citizenship:
How long did you live in your Country of Citizenship?
Country of Permanent Residence:
How long did you live in your Country of Permanent
Residence?
Immigration Status (e.g.: F-1/J-1):
Current Classification:
Have you applied for US permanent resident status (or has someone else applied for you)?
Yes
No
Have you received the Good Neighbor Scholarship before?
Yes
No
Do you have any relatives working for the Texas Higher Education Coordinating Board?
Yes
No
Do you plan to return to your home country after completing your degree/OPT?
Yes
No
Are you a member of the Communist Party?
Yes
No
Statement of Financial Need
Please explain, in details, your need for financial assistance. Consider the following questions:
Has there been a sudden change in your financial situation since receiving your current
I-20? Explain why you can no longer meet your financial needs and how you will manage
those needs if you do not receive any financial assistance. Please, provide a thorough
explanation of your need. Please, use proper MLA/APA writing form in this section.
Statement of Future Goals
Pease describe how you plan to impact your home country and community once you return to
your home country to begin your career. Please include any short or long term goals related to
your education and future career that will have a positive impact on your home country.
Statement of Authenticity
By checking the button below, you are certifying that the statements and indications you made
on this form are true and accurate to the best of your knowledge.
Yes, the statements I have made on this form are true and accurate.
No, the statements I have made are either untrue or inaccurate.
Supporting Documentation
Please e-mail this completed application to Michael Murphy at michael.murphy@ttu.edu. It is
highly recommended that you also include supporting documentation such as pay stubs,
bank statements, transcripts and any evidence that supports your claim in having a sudden
change in your financial situation. The more evidence you include to support your financial
claims about your family and yourself, the more compelling your case is to receive the Good
Neighbor Scholarship.