The Josiah N. Moore Memorial Scholarship 2015 - 2016 Scholarship Application The Josiah N. Moore Memorial Scholarship is made possible by an Endowment at the ASU Foundation created by the family of Josiah N. Moore, former Chairman of the Tohono O’odham Nation and English Professor at ASU. Administered by the ASU Native American Alumni Chapter, the scholarship was created to assist with the educational needs of American Indian students at ASU. The scholarship amounts awarded will be two (2) $2,000 scholarships, one for a current undergraduate student and one for a current graduate student. Two (2) $1000 scholarships will be awarded to the second place applicants. The amounts listed will be distributed half in the fall and half in the spring semester through ASU Financial Aid Office. SCHOLARSHIP CRITERIA: Must be enrolled in a federally recognized Indian tribe (must provide Certificate of Indian Blood/Enrollment number or Tribal ID). Open to undergraduate and graduate students. Undergraduate applicants: Must be enrolled full time with a minimum of 12 credit hours per semester at any of ASU’s four campuses. Minimum of 24 credit hours completed at ASU Cumulative ASU GPA of 3.0 or above. Must show financial need as determined by the ASU Financial Aid Office. Graduate applicants: Must be regularly admitted to a graduate program. Must be enrolled full time with a minimum of 9 credit hours per semester at any of ASU’s four campuses. Must show financial need as determined by the ASU Financial Aid Office. APPLICATION PROCEDURE: 1. Complete the application form. 2. Submit a copy of Certificate of Indian Blood/Enrollment Number. 3. Provide one (1) letter of recommendation from a non-family member (advisors, counselors, faculty members, professors, etc). 4. Submit a personal goal statement 5. Submit financial information and need statement. 6. Submit copy of unofficial transcripts. ELIGIBILITY - Scholarship criteria must be met at time of application as well as during academic year specified on application. FULL-TIME - Carrying and completing 12 credit hours or more each semester for undergraduate applicants and 9 credit hours or more each semester for graduate applicants. REAPPLYING - Students must apply each year to be considered for renewal. *If selected, student awards will be disbursed in the Fall and Spring* DEADLINE – Friday, October 9, 2015 by 5 pm to the address indicated below. Mailed submissions must be post marked by Wednesday, October 7, 2015 Submit your original application packet to: ASU Alumni Association Attention: Native American Alumni Chapter Old Main Box 873702 Tempe, AZ 85287-3702 For additional information or questions contact: Shauna Allison Justin Hongeva shauna.allison@asu.edu jhongeva@asu.edu The Josiah N. Moore Memorial Scholarship SCHOLARSHIP APPLICATION 2014 – 2015 ACADEMIC YEAR I. GENERAL INFORMATION Name: ASU ID#: Tribal Affiliation(s): Local Address: (Include City, State & Zip Code) Phone Number: (H): (W): Email: Cell Number: II. EDUCATIONAL INFORMATION Current class standing (circle one): FR SO JR SR Anticipated graduation date:____________ College: Major/Minor: ASU cumulative hours completed to date: ASU cumulative grade point average: III. SCHOLARSHIP AGREEMENT I give my permission for the release of academic, financial, and/or other necessary information requested by the scholarship/award selection committee. Further, if a scholarship/award is awarded to me, my consent is hereby given for the release of academic, financial, or other necessary information requested by the scholarship/award donor. I certify that the information throughout this application is accurate (and in compliance with the criteria stated on scholarship), and that misrepresentation of any facts or details could result in ineligibility for any scholarships/awards. I hereby agree upon the acceptance of the scholarship/award to the terms specified in the scholarship criteria. However, should my status change whereby I no longer meet the criteria, I understand that the scholarship will be revoked. If I receive an scholarship/award, I agree to attend the Josiah N. Moore Scholarship Benefit Dinner to personally accept the award and volunteer time at Native American Alumni Chapter functions. This typically includes: JNM Scholarship Benefit Dinner – November 7, 2015, ASU Old Main Carson Ballroom Fall/Spring Native American Convocation – December 2015/May 2016 Signature: Date: 1 The Josiah N. Moore Memorial Scholarship SCHOLARSHIP APPLICATION 2015 – 2016 ACADEMIC YEAR IV. FINANCIAL INFORMATION Name: ASU ID#: Financial need is an important factor the Native American Alumni Chapter considers in awarding scholarships. List all scholarships, financial awards, grants and/or loans, and their amounts, that you are currently receiving: $ $ $ $ $ $ TOTAL $ List all scholarships, financial awards, grants and/or loans, and their amounts, that you anticipate receiving the next academic year (2015-2016): $ $ $ $ $ $ TOTAL $ ATTACH A ONE-PAGE, DOUBLE-SPACED, STATEMENT OF YOUR FINANCIAL NEED FOR THE NEXT ACADEMIC YEAR TO THIS PAGE. CLEARLY show “anticipated” monies received versus anticipated expenses. This would include scholarships, grants, loans, wages or assistance from parents. If you work during the academic year, provide the number of hours you average each week. Explain any special circumstances you wish the Scholarship Committee to consider. Make sure to include your ASU ID on your Financial Need Statement. 2 The Josiah N. Moore Memorial Scholarship SCHOLARSHIP APPLICATION 2015 – 2016 ACADEMIC YEAR V. PERSONAL GOAL STATEMENT ATTACH A PERSONAL GOAL STATEMENT AT THE END OF YOUR APPLICATION PACKET. The Scholarship Committee STRONGLY weighs this statement in determining scholarship recipients. Your statement should be typed, double-spaced and no more than two pages in length. The content, punctuation and grammar of this statement greatly impact your ability to compete for our scholarships. Make sure to include your ASU ID on your Personal Goal Statement. Consider providing the following information: What are your current and future career goals? How have you been involved in your community? What civic, church, or school/college organizations have you, or are you an active member of? How have you been an active member? What leadership roles/positions have you held in these organizations? What honors or awards have you received? Are there any extraordinary situations you wish the Native American Alumni Chapter to consider? How will this scholarship help you meet your academic and career goals? TIPS & CHECKLIST TIPS Print legibly in black ink or type. Check your grammar, spelling and punctuation. It matters. Make sure your address, phone numbers and email addresses are correct. If they change, please contact Shauna Allison at shauna.allison@asu.edu or Justin Hongeva at jhongeva@asu.edu Be sure to indicate the easiest way to reach you. Do not forget to sign and date the application. CHECKLIST Make sure the following are complete and included in your application packet: ____ General information ____ Educational information ____ Scholarship agreement ____ Copy of unofficial transcripts ____ Copy of Certificate of Indian Blood/ Enrollment Number ____ Financial information ____ Financial need statement ____ Personal goal statement ____ One letter of recommendation ____ ASU ID# on all forms SCHOLARSHIP DEADLINE: October 9, 2015 If mailing, must be post marked by October 7, 2015 3