William C. and Annette Rock Study Abroad Scholarship in the Liberal Arts
William C. and Annette Rock established this scholarship to provide students in the School of the Arts, Humanities and Social Sciences the
opportunity to study abroad. Applicants must be an undergraduate in good standing in an academic program within the School of the Arts,
Humanities and Social Sciences, they must demonstrate academic excellence as judged by a committee comprised of faculty in the School of
the Arts, Humanities, and Social Sciences and have been accepted into a study abroad program.
Complete the following:
Name:
Banner ID:
Last
First
Middle/maiden
Brockport address:
Permanent address:
Street
Phone numbers:
City/Town /State
Zip
/
Cellular
Local
/
Permanent
E-Mail Address:
Academic major:
Institutional GPA:
Minor:
Certification:
Credit hours completed:
Credits in progress:
Anticipated graduation date:
The College at Brockport Study Abroad Program
Departure date:
Return date:
Applicant’s signature________________________________________Date__________________
Attach an essay, not to exceed two (2) typed pages describing the study abroad program you have chosen and your reasons for selecting
it. How does it relate to your personal and professional goals? What do you expect to be your biggest challenge and what do you
expect to gain? Please include biographical information and discuss why you should be the recipient of this scholarship.
Attach two letters of recommendation from two professors. Please list their names below:
1.
Name
Address
Telephone
Name
Address
Telephone
2.
ATTACH ESSAY, FINANCIAL AID INFORMATION RELEASE FORM, DEGREE AUDIT REPORT (DARS)
AND 2 LETTERS OF RECOMMENDATION TO THE COMPLETED APPLICATION.
SUBMIT THESE MATERIALS TO: School of The Arts, Humanities and Social Sciences, Office of the Dean, 258
Brown Building, The College at Brockport, Brockport, New York, 14420; or via e-mail to rglazer@brockport.edu.
DEADLINE FOR RECEIVING THIS FORM AT THE ABOVE ADDRESS IS APRIL 2.
For additional information, please visit: www.brockport.edu/scholarships
For office use only: Institutional GPA _____
Major GPA _____
Minimum Credits Completed _____
Financial Aid Information Release Form
William C. and Annette Rock Study Abroad Scholarship in the Liberal Arts
It may be necessary at some point in the application process for our office to obtain financial aid information from
the Financial Aid Office. We ask for your consent by having you and your parent sign the letter below authorizing
the use of this information. Demonstrated financial need is determined by the Free Application for Federal
Student Aid (FAFSA) minus any other awarded scholarships or grants.
Signature:
Date:
Parent Signature (if necessary):
Date: