PRAIRIE VIEW A&M UNIVERSITY
Roy G. Perry College of Engineering
Scholarship Application Checklist
REQUIRED DOCUMENTS
 Typed Scholarship Application
 Personal Statement
 Updated Resume
 Transcript
a. High School Students – Unofficial copy of High School Transcript
b. Current Students – Unofficial copy of transcript through registered semester
c. Transfer Students – Unofficial copy of “other” university transcript
 Teacher Recommendations (2)
a. High School Students – High School Teachers (Math, Science, Technology), Counselors or
Principals
b. Current Students – Engineering, Math or Science Professors
c. Transfer Students – Math, Science, Technology teachers from the institution of transfer
OPTIONAL DOCUMENTS
 Financial Aid Award Letter
 Detailed Class Schedule
NOTE: All application materials MUST be typed (excluding Recommendation Forms) and submitted to the
Office of the Dean in an envelope or folder.
Scholarship Application Deadlines
Semester
Deadline to Submit Completed Application
Summer 2013
March 15, 2013
Fall 2013
April 15, 2013
Spring 2014
September 15, 2013
All scholarship awards are contingent upon the applicant providing final transcripts and enrolling full-time
at Prairie View A&M University.
Roy G. Perry College of Engineering
Scholarship Application
DIRECTIONS: Please complete ALL sections of the application. Type N/A for questions that do not apply.
APPLICANT INFORMATION
Name
Student ID Number
Date of Birth
Mailing Address
City
State
Zip
Phone
E-Mail Address
Male
Black/African American
White (Not Hispanic)
Hispanic
Asian/Pacific Islander
Cell Phone
Female
American Indian
Other ______________________________
Citizenship & Residency
Are you a U. S. Citizen?
Yes
No If No, what Country are you a citizen? ______________________________
Are you a Resident of Texas?
Yes
No If No, what State are you a resident? _________________________________
EDUCATION
Current College Students ONLY
Major
Degree:
______________________________
B.S.
Cumulative GPA:
___________________________
M.S.
Previous Semester GPA: ______________________
Ph.D.
Total number of hours completed: ______________
Current High School Students ONLY
Name of High School: ______________________________________
High School GPA: ____________________
ACT Score: __________________________
Graduation Date: _________________________
SAT Score: __________________________
Type of Applicant:
Classification (at time of application):
Incoming Freshman
Freshman
Return Student
Sophomore
Transfer
Junior
Incoming Graduate Student
Senior
Returning Graduate Student
Organization Membership
Extracurricular
Activities
Community Involvement
1
Leadership Roles
Name
Student ID Number
Have you completed the Free Application for Federal Student Aid (FAFSA)?
Are you currently receiving financial aid (grants, loans, work-study, or
scholarships)?
Where do you live/plan to live?
Date of Birth
Yes
No
Yes
No
On-Campus
Off- Campus
PERSONAL STATEMENT
ESSAY REQUIREMENTS:
A personal statement of 500 words of less must be included with the application packet. Personal statements
should include factors such as extenuating circumstances including (but not limited to) socio-economic
background, ideological viewpoint, disability, etc in their evaluation of the application. Personal statements
may also include: (1) how your personal background impacted or can impact your first-year as an engineering
student, (2) professional goals, (3) your scholarly interest or both academic research and/or (4) an experience,
class or person that significantly changed or impacted your life and/or how your identity or background will
contribute to diversity in your chosen profession. Applicants may also discuss why they are in majoring in
engineering, computer science, and/or technology.
I certify that the information provided on this application is complete and accurate. I understand that providing false,
misleading or incomplete information will be the basis for denial or revocation of scholarship funds. I understand that the
Office of Student Financial Services and the Roy G. Perry College of Engineering reserves the right to modify my award
(financial aid/scholarship, etc.) at any time due to changes in my eligibility, enrollment status, housing status, availability
of funding; or receipt of any funds not included in my original award.
If necessary, Prairie View A&M University may release my academic information to University Colleges/Departments as
well as outside donors. Prairie View A&M University has permission to release this information for review, recruitment
and public relations. I further understand that awards depend on the availability of funds and financial need.
Student Signature
Date
2
Revised December 2012