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:
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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.
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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
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