Undergraduate Student Scholarship Application
2014 - 2015
Contact Information
Name __________________________________
PeopleSoft ID _________________
Address _______________________________________________________________
City ___________________
State _______ Zip code _________________________
Phone number ______________________ Date of Birth ________________________
Email _________________________________________________________________
Personal Information
Are you a U.S. citizen?
Yes
No
Yes No
Are you a Texas resident?
If not, in which state do you have residency? ___________
Academic Information
Full time enrollment (12 hours) each semester is a requirement for this scholarship.
Check this box to acknowledge that you understand if this requirement is not met, the
award will be revoked.
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Enrollment Status
Freshman (0-29 hours)
Junior (60-89 hours)
Sophomore (30-59 hours)
Senior (90+ hours)
Major(s) ______________________________________________________________________
Minor(s) ______________________________________________________________________
Overall GPA ________________________ Communication GPA _______________________
Total college credits earned ____________
Communication credits earned ________________
Expected date of graduation __________________________
List your academic honors and other accomplishments. Attach additional sheets, if necessary.
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List your college and community activities and clubs. Specify offices held, where appropriate.
Attach additional sheets, if necessary.
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Financial Need
Will you be employed while attending school?
Yes, full-time Yes, part-time No
If yes, indicate:
Work source _________________________________
Monthly income _______________________________
Annual income including this job and other sources $___________________________________
Are your parents or family contributing to the cost of your education?
If yes, how much per year? $________________________________
Yes
No
Have you now, or will you have, any other type of financial assistance, such as scholarships,
Yes No
loans, fellowships, or work-study programs?
If yes, please specify the sources of financial assistance and the approximate amounts.
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Are there any specific circumstances complicating your ability to pay for college?
______________________________________________________________________________
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Essay
Please submit a typewritten essay answering the following:
1. Why did you select communication as your major?
2. What specific area of communication most interests you? Why?
3. What communication related activities (on and off campus) have you been involved in? How
have you contributed? Activities may include internships, jobs, school projects, community
outreach, and/or academic research.
4. What are your goals in 5 years? In 10 years?
5. Describe your dream job.
6. Describe your most rewarding communication related experience.
7. How will your college career improve your value as a communicator?
8. What does being a UH Cougar mean to you?
9. After graduation, how do you plan to stay involved in the School of Communication and the
University of Houston?
You may include additional information that you would like the selection committee to consider.
Please double check that your application is complete.
Incomplete applications will not be considered.
Completed and signed application
Essay
Official college transcript(s)
Minimum two letters of recommendation
I hereby certify that to the best of my knowledge the information contained in this application is
true and correct. I authorize the Houston Alumni Association to verify any information relevant
to my admission to the University of Houston or claims made herein. I agree to release any
information concerning my records at the University of Houston to any federal, state, or private
agency necessary solely for the administration of the scholarship program.
Applicant Signature __________________________________
Date __________________
Complete application package must be postmarked by April 18, 2014 and mailed to:
VSOCAA Scholarship Committee
Houston Alumni Association
P.O. Box 230345
Houston, Texas 77223-0345
Questions? Please contact Tempest Solcich at tsolcich@gmail.com
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