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 Applicationpage 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 Applicationpage 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 Applicationpage 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 Applicationpage 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 Applicationpage 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 Applicationpage 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 Applicationpage 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 Applicationpage 8 of 8