Passport Assistance Scholarship Application
Student Name
(include middle name)
MTSU
E-Mail
Major(s)
Class Level
FR
ID/M
Number
Alternate
E-Mail
SO
Do you have a Pell Grant?
JR
Yes
SR
No
GR
College GPA
Minor(s)
Cell
Phone
Have you taken Honors classes?
List three countries (in preference order) where you are interested in studying abroad:
Do you have a specific semester that you would like to study abroad? If so, when?
In a paragraph, list one or two things that interests you about your top country:
How does a passport and an international experience enhance your future career goals?
Have you gotten a passport before?
Yes
No If so, when?
Have you previously applied for the Honors Passport Scholarship?
Yes
No
What times on Wednesday, March 16, 2016 are you available? Check all that apply.
10:00 -10:30 a.m.
12:30 to 1:00 p.m.
10:30 - 11:00 a.m.
1:00 - 1:30 p.m.
11:00 - 11:30 a.m.
1:30 - 2:00 p.m.
11:30 a.m. - 12:00 p.m.
Do you have the following documents available, if needed?
Proof of Citizenship
Valid Driver's License
two (2) checks to cover $150
DEADLINE TO APPLY: FEBRUARY 12, 2016
RETURN FORM TO HONORS COLLEGE, ROOM 205
YOU MUST BE AN HONORS STUDENT TO BE ELIGIBLE
Student Signature
DO NOT WRITE BELOW THIS LINE. For Office Use Only.
COMMENTS/FOLLOW-UP:
Today's Date
Print Form
Yes
No