SCHOLARSHIP APPLICATION FOR RETURNING
AND TRANSFERRING STUDENTS
Recipients of UW- Sheboygan scholarships are chosen by the Student Aid, Awards, and Appeals (AAA) Committee, or in some
cases, the organization providing the scholarship. The AAA Committee is made up of three faculty/staff members, two
students, and two non-voting members of Student Affairs. Most scholarships are awarded for one academic year with one-half
of the funds distributed upon first semester (Fall 2016) registration and one-half distributed upon second semester (Spring
2017) registration. Only those scholarships specifically identified as Transfer Scholarships can be applied to other campuses.
Scholarship awardees will be recognized at the UW-Sheboygan Honors and Recognition Night, Tuesday, May 10, 2016, 6:00
p.m.
.
Please respond to all of the questions, and write "NA" (not applicable) if appropriate. Recipients of the various scholarships
will be determined based on the information provided on the application form. Although most scholarships are awarded
primarily for academic achievement (minimum cumulative 3.0 G.P.A.), other considerations such as extra-curricular activities
and financial need, play an important part in the selection process. The Student Aid, Awards, and Appeals Committee reserves
the right to interview any and all applicants.
Students receiving financial aid are also eligible to apply for scholarships because these funds are separate from UW Colleges
Financial Aid Office funds. Students are also encouraged to check with Student Affairs for additional scholarship opportunities
which are not administered by this campus. You can check out the tentative list of scholarships at:
http://www.sheboygan.uwc.edu/money-matters/financial-aid/scholarships.
RETURN THIS APPLICATION FOR UW SHEBOYGAN SCHOLARSHIPS
AND YOUR 1-2 PAGE PERSONAL STATEMENT (See #13)
TO THE STUDENT AFFAIRS OFFICE BY 4 P.M. MONDAY, FEBRUARY 29, 2016
(1) Name:__________________________________________________________________________________
(2) Address:_____________________City _____________________ WI Zip ____________________________
Phone Number(s): __________________
______________________
(3) During the Fall 2015 semester at UW- Sheboygan, I was:
____ Enrolled as a full-time student ____ Enrolled as a part-time student ____ Not enrolled
(4) During the Spring 2016 semester at UW- Sheboygan, I am:
____ Enrolled as a full-time student ____Enrolled as a part-time student ____Not enrolled
(5) The college I plan to attend for the Fall 2016 Semester is:___________________________________________
as a: ____Full-time student
____Part-time student
(6) The college I plan to attend for the Spring 2017 semester is: _________________________________________
as a: ____Full-time student
____Part-time student
(7) The total number of college credits I will have earned at the end of the Spring 2016 semester:
____29 or less
____ 30 or more
(8) Intended academic major:____________________________________________________________________
(9) UW Sheboygan extra-curricular activities (Include organizations and offices held):
(10) Community activities (include organizations and offices held):
(11) Other life/work experiences:
(12) Are you a first generation college student? ____No ____Yes
(Yes, if your parents did not attend college)
Personal and Educational Goals
(13) Please attach a one or two page typed essay that discusses some aspect of your personal and
educational goals that you would like the committee to consider.
PART 2 - FINANCIAL INFORMATION
Students Earned Income
(14) Total income from all sources of employment for 2015-2016 academic year:
____________________________________________________________________________________
(15) Occupation(s): ________________________________________________________________________
(16) Employer(s): ________________________________________________________________________
(17) Other information on employment income that should be considered by the committee.
____________________________________________________________________________________
Other Income or Financial Support
(18) Have you been awarded a scholarship for 2016-17?
____No ____Yes
(19) Do you receive veteran's, social security, or similar benefits? ____No ____Yes
Amount: ____________
Amount: ____________
(20) Do you have other sources of trust or interest income?
____No ____Yes
Source(s): ______________________________________ Amount(s) _____________________
(21) Do you receive child support or alimony payments?
(22) Do you have any other sources of income?
____No ____Yes
____No ____Yes
Amount: _____________
Amount: ____________
Parental Legal Guardian Financial Responsibilities
(23) Do you live with a parent or legal guardian?
____No ____Yes
(24) Do you receive any direct or indirect (i.e., room and board, clothing) financial support from your parent/legal
guardian?
____No (If No, SKIP TO QUESTION 29) ____ Yes
(25) Estimated percentage of educational expenses provided by your parent/guardian for 2016-2017 academic year:
(26) Estimated percentage of non-educational expenses provided by your parent/guardian for 2016-2017 academic year:
(27) Gross annual income of your parent/guardian (before deductions):
____ Below $15,000
____ $40,000 to 49,999
____ $15,000 to 19,999
___ $50,000 to $59.999
___ $20,000 to 29,999
____ $60,000 to 69,999
____ $30,000 to 39,999
____ $70,000 or more
(28) Number of dependents claimed by your parent/guardian for income tax purposes:________________
Relationship to your parents of each individual so claimed:___________________________________
Married Financial Responsibilities
(29) Do you receive any direct or indirect (i.e., room and board, clothing) financial support from a spouse?
____ No (If No, SKIP TO QUESTION 34) ____ Yes
(30) Estimated percentage of educational expenses provided by your spouse for the 2016-2017 academic year:
(31) Estimated percentage of non-educational expenses provided by your spouse for 2016-2017 academic year:
(32) Gross annual income of your spouse (before deductions):
____ Below $15,000
____ $15,000 to 19,999
___ $20,000 to 29,999
____ $40,000 to 49,999 ___ $50,000 to $59.999
____ $60,000 to 69,999
____ $30,000 to 39,999
____ $70,000 or more
(33) Number of dependents claimed by your spouse for income tax purposes? _____________________
Relationship to your spouse of each individual so claimed:__________________________________
Other Financial Responsibilities
(34) Are there any individuals for whom you are financially responsible? ____ No ____ Yes
Relationship to you and the extent to which you financially support each person:
_________________________________________________________________________________
(35) Other financial responsibilities (Attach a short statement on a separate sheet if necessary):
_________________________________________________________________________________
I certify that to the best of my knowledge all information provided on this application is true and correct, and that the UWSheboygan Student Aid, Awards and Appeals Committee and other scholarship committees have my permission to review my
permanent file as maintained by the UW- Sheboygan Student Affairs Office.
___________________________________________________________
Signature
10/20/2015
_________________________
Date