Scholarship Agreement Panther Pipeline Nuclear Program Department of Chemical Engineering (Nuclear Program) University officials may renegotiate this agreement at the beginning of each semester. Prairie View A&M University hereby awards the TWC - Panther Pipeline Scholarship to: _______________________ up to the amount of approximately $_________ for Fall 2006 and Spring 2007. The terms and conditions of the award are outlined in Part A below. The scholarship amount may be adjusted by University officials. The funds of this award can only be applied to required tuition and fees, the university meal plan, on-campus residence housing, books and educational supplies while attending Prairie View A&M University. Instructions: Please complete either Part A or Part B, and Part C of this agreement. Part A (Acceptance) I, _____________________________________, UIN _______-_____-________ accept the Panther Pipeline Scholarship. (Print Your Full Name) Accepting this scholarship means that I agree to the following guidelines: 1. I must be a U.S. citizen (or permanent resident) and submit all forms required to maintain admission to PVAMU. 2. I must use the scholarship to pay the cost of attending Prairie View A&M University. I understand that expenses above the amount of this award are my responsibility. 3. I understand that the Panther Pipeline Program also reserves the right to modify my award at any time due to changes in my eligibility, enrollment status, housing status, availability of funds, or receipt of any scholarship funds not included in my original award. 4. I am only required to register for minimum of 6 semester credit hour of nuclear engineering course work as outlined in the Panther Pipeline Program. I am required to apply for at least one summer internship position related to nuclear engineering field. 5. I must earn a minimum grade point average (GPA) of 3.0 on a 4.0 scale in the program courses. 6. If I fail to meet the minimum qualifications (3.0 GPA) my scholarship may be forfeited, if satisfactory progress is not made. 7. I understand the scholarship will be forfeited in the event I am suspended from the University for violating the University’s disciplinary code. 8. If I use false information to obtain the scholarship, the scholarship may be forfeited and I may be required to repay all monies received. 9. I may not receive a notice of current scholarship status, but I will be responsible for adhering to the written scholarship agreement during my tenure on scholarship. 10. I will participate in Panther Pipeline Program organized scholarly activities. Part B (Decline)) I, _____________________________________, UIN _______-_____-______ decline the Panther Pipeline Scholarship. Part C (Signature and Address) Student Signature:________________________________ Date: _________ E-mail:_______________________ Address: _________________________________________________________________________________ Street City State Zip