2015Truman Application.doc

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Truman Scholarship 2015
Application for Willamette Nomination
CAMPUS DEADLINE: April 20, 2015
Office of Student Academic Grants and Awards
100 Matthews Academic Commons
A complete nomination application consists of:
1. The WU/Truman Application
2. A 500-word description of a policy issue related to your public service interests.
3. A current transcript (unofficial is OK)
4. Names, campus phone number, and departmental affiliation of three faculty references. (Do not request
letters; the Grants & Awards committee will contact references.)
Please note: application materials are to be submitted electronically only, to the WISE site called SAGA
Applications. Instructions for joining the site may be found here: http://www/wits/wise/how_to/join-site.html
References:
Name:
Dept.:
Campus Phone:
Name:
Dept.:
Campus Phone:
Name:
Dept.:
Campus Phone:
WU Truman Applicationpage 1 of 8
Willamette Campus Application for the
2015 Truman Fellowship Nomination
Legal Name in full
(Print/Type)
Permanent
residence
Last Name
First Name
F
State
ZIP
State
ZIP
Number, Street and Apartment #
City
How is permanent residence established? (At least two must apply.)
Home address for school registration
Home telephone
School telephone
Place of registration to vote.
(if
different)
Family’s Primary residence
E-mail
address
Other
Date of Birth
(Check one) I am a
M
Number, Street and Apartment #
City
Your address at
school (if different)
Sex:
M.I.
US Citizen
US national
Will you be studying abroad in Fall 2015
Current cumulative GPA
Yes
No
(
(
)
)
/
/
Resident alien expecting citizenship by May 23, 2015
or Spring 2016?
Yes
No
Your undergraduate major(s)
Number of college credits received to date
Total number of credits required for graduation
Expected date to receive baccalaureate degree
Degree you will receive
Graduate degree(s)
Concentration(s)
sought
If you have more activities, work experience, and/or awards than the space allows, list only those you consider most
significant. Inserts, attachments, and additional pages will not be accepted.
1. List the secondary school from which you graduated, and all higher education institutions attended. Include
summer, study-abroad, exchange programs and your nominating institution.
School
Location
Dates Attended
WU Truman Applicationpage 2 of 8
2. List college and high school activities (student government, sports, publications, school-sponsored community
service programs, student-faculty committees, arts, music, etc.) List in descending order of significance.
College Activity
Dates
Offices
High School Activity
Dates
Offices
3. List public service and community activities (homeless services, environmental protection/conservation,
advocacy activities, work with religious organizations, etc.). Do not repeat items listed previously. List in
descending order of significance.
Activity
Role
Dates
WU Truman Applicationpage 3 of 8
# of Weeks
Active
3. Public Service (cont’t.)
Activity
Role
# of Weeks
Active
Dates
4. List government activities (internships with government agencies, partisan political activities, ROTC/military,
municipal boards and commissions. List student government under Item 2.
Activity
Role
# of Weeks
Active
Dates
5. List part-time and full-time jobs and nongovernment internships since high school graduation.
Type of Work
Employer
Dates
Average #
Hours/Week
6. List awards, scholarships, publications or special recognitions you have received. List in descending order of
significance.
WU Truman Applicationpage 4 of 8
7. Describe one specific example of your leadership.
8. Describe a recent particularly satisfying public service activity (do not repeat experience described in 7).
WU Truman Applicationpage 5 of 8
9. Describe the problem of society you want to address when you enter public service. (If possible, use statistical
data to define the magnitude of the problem.
10. What are the three most significant courses you have taken?
WU Truman Applicationpage 6 of 8
11. If selected a Truman Scholar, would you apply for the Summer Institute? (If yes) With which federal executive
branch agency would you like to work? What issues would you like to address?
12. Describe the graduate education program you intend to pursue if you receive a Truman Scholarship .
13. What do you hope to do and what position do you hope to have upon completing your graduate studies?
WU Truman Applicationpage 7 of 8
14. What do you hope to do and what position do you hope to have five to seven years later?
15. What additional personal information do you wish to share with the Truman Scholarship Foundation?
I authorize the Office of Student Academic Grants & Awards to
conduct a routine inquiry of my references, conduct records and
academic standing. I understand that this information will be
shared with members of the selection committee for evaluation
purposes.
Signature of Applicant
Date
WU Truman Applicationpage 8 of 8
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