UNIVERSITY OF NORTH FLORIDA FOUNDATION
Jack Slaughter & Sam Jacobson
Endowed Scholarship
VALUE: $1,000 ($500 Fall / $500 Spring)
NUMBER:
One
Preference given, but not limited to students who are members of the UNF Pride
Club and students who register at the LGBT Resource Center.
CRITERIA:
Applicants must:
 Meet admissions requirements and be accepted to the University of North Florida,
 Enroll for a minimum of 12 credit hours each semester and earn a minimum of 24
credits by the end of each academic year,
 Reside in Baker, Clay, Duval, Nassau or St. Johns county,
 Work to support themselves or a household,
 Preference given, but not limited to students who are member of the UNF Pride Club
and students who register at the LGBT Resource Center,
 File a FAFSA and demonstrate financial need.
STUDENT RESPONSIBILITY:
Recipients must:
 Enroll for a minimum of 12 credit hours each semester and earn a minimum of 24
credits by the end of each academic year,
 Maintain a GPA of at least 3.0,
 Remain in good standing as a student
 Comply with all University regulations, rules, and codes of conduct governing
students on campus,
 Consent to release grades to the Division of Institutional Advancement for the
purposes of reporting to the donors,
 File a FAFSA each year, and
 Remain in good standing as a student.
RENEWAL:
Current recipients may apply for renewal and will be given preference pending availability of
funding, and if all of the preceding requirements have been met. No student will be eligible to
receive more than eight semesters of scholarship support.
Submit your application to
k.legg@unf.edu
Only electronic applications will be considered.
Submission Deadline:
March 21, 2016
2016-2017 Scholarship Application
Deadline: March 21, 2016
Jack Slaughter & Sam Jacobson
Endowed Scholarship
Last Name
Preferred Name (if different than
legal name)
(Legal) First Name
City
Permanent Address
UNF email Address
Phone
State
Date of Birth
/
Rank at completion of Spring 2014 semester (check one only)
UNF ID (“N” Number)
/
Zip Code
Male
Female
________
Gender
pronouns:
Major(s) or Intended Major(s)
UNDERGRADUATE
Freshman
_________________________
Sophomore
Junior
Senior
Calculate the number of credit hours
completed at UNF as of the end of Spring 2016
UNF Cumulative GPA
Proposed Graduation Date
(semester / year)
LOWER LEVEL (1000-2000):
UPPER LEVEL (3000-6000):
Overall GPA
FOR OFFICE USE ONLY
Verifier:
UNF Cumulative GPA:
High School/Transfer GPA:
Criteria Met?
YES
Major:
Expected Graduation:
NO
Graduate
Undergraduate
Other Information:
Overall GPA (transfer and institutional together)
Co-curricular Activities: Include college and community activities, volunteer work and honors.
Month / Year TO Month / Year
Description of Activity and Leadership Role (if any)
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Work Experience
Month / Year TO Month / Year
Company and Description of Work
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Hours per Week
Military Experience
Branch of Service
Description
Dates Served
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Additional Required Information
Are you the first person in your family to attend college or receive an undergraduate degree
(which could identify additional scholarships for you)?
YES
NO
Have you filed the FAFSA form (as required by the State and to assist you with any other
possible scholarships)?
YES
NO
Have you applied for or are you receiving any other scholarships (i.e. Bright Futures, grants or
gift aid) at UNF?
If yes, please list:
YES
NO
Essay & Documentation
Please write a 500 word essay response for each of these additional questions.
 Please write a brief biography, including any hardships you have overcome and aspirations for
the future, or service to the community
 Describe your involvement (if any) in events or programs related to LGBTQ identities and/or
social justice (such as with UNF Pride Club or the LGBT Resource Center)
 Describe how the scholarship will help enhance your UNF academic and transformational
experiences
YES, I have read and accept the terms below.
I affirm that the information which I have provided on this application form and any additional material that
I submit related to the financial aid process is complete, accurate and true to the best of my knowledge.
Pursuant to the Family Educational Rights and Privacy Act of 1974, as amended (FERPA), I hereby
authorize the University of North Florida to release the scholarship application information provided by
me, as well as other official and unofficial University of North Florida information regarding my academic
progress and status, to scholarship donors for the purpose of providing the donors with information
concerning my eligibility as a scholarship recipient. I also understand that furnishing false information may
result in revocation of my scholarship or may result in disciplinary action pursuant to the University of
North Florida Student Conduct Code.
Applicant’s Name
Date
Submit to k.legg @unf.edu. Only electronic applications will be considered.