Graduate College and Graduate Student Government Scholarships
Checklist and Application Form
2016-17
Name:
This application form is for scholarships awarded through the Graduate College and the Graduate
Student Government and can only be used for students admitted into a graduate-level degree
program at NAU. Please indicate “yes” or “no” to the following items:
1.
2.
3.
4.
5.
Admitted to NAU as a full-time, degree-seeking graduate student for the academic year?
Full-time graduate assistant for 2016-17? (full-time equals 20 hours per week)
Preregistration completed for classes indicated on application form?
Current FAFSA application on file for 2016 (if you are a US resident)?
Funding from other sources for 2016-17? (Indicate details on application form)
Complete Graduate College scholarship CHECKLIST above and APPLICATION FORM below, sign, and
date.
Please attach a PROFESSIONAL, WELL-WRITTEN STATEMENT that is approximately one page in length.
In this statement, you will need to provide information explaining the reasons behind your decision to
pursue a graduate degree and its relationship with your career goals and aspirations, and include other
pertinent information related to specific scholarship criteria.
POSTMARKED APPLICATION DEADLINE: March 1, 2016
Send scholarship application form, checklist, and statement (essay) as one PDF attachment via e-mail to
GradAwards@nau.edu.
For additional information or questions contact Kirsten Slaughter-Rice at
Kirsten.Slaughter@nau.edu or (928) 523-4338.
1
Graduate College and Graduate Student Government Scholarship Application 2016-17
Name:
Academic Plan:
Full Address:
NAU ID:
Email:
Telephone:
Cell Phone:
@nau.edu
Yes
Are you a member of a federally recognized Native American nation or tribe?
 If you answered “Yes” to the above question, please list
the federally recognized Native American nation or tribe:
Educational Background: (please include NAU graduate study or planned study)
College/University
College/University
No
College/University
Name:
Location:
Dates Attended:
Major:
Degree:
Date of Degree:
Final GPA:
Courses: (List course prefix/numbers and titles to be taken during Fall and Spring 2016-17.)
Fall 2016
Spring 2017
Scholarships & Financial Aid Awards: (List all sources and amounts you have applied for or know you will receive
for 2016-17)
1.
2.
3.
4.
5.
6.
Employment (Specify name of employer, job title, responsibilities, length of employment. You may attach a
resume).
2
Honors and Awards:
Extracurricular Activities:
Community Service and Volunteer Activities:
Miscellaneous: (any other accomplishments you would like to note)
Supplemental Information: To give your scholarship application full consideration, answer the following
questions. If you indicate a yes response to questions 1-3, please provide an additional sheet with details on your
response.
1. Are you a returning student? (started your graduate education, left school, and are
Yes
No
now returning)
2. Are you eligible for tuition benefits through employment, or as a dependent,
Yes
No
domestic partner, or a spouse of an employee at a state university in Arizona?
3. Are you considered an Arizona resident?
Yes
No
Professional or Academic References:
Name
Telephone
E-mail
I confirm by my signature below that the information I have provided on this application is accurate and true to
the best of my knowledge. I understand that the scholarship is awarded at the discretion of the Graduate College,
and I give Graduate College staff permission to contact my school(s) or other references for verification of this
information. I also understand that by asking to be considered for a Graduate College scholarship, I am giving
consent for NAU to release my personal information to donors or within press releases or feature articles. This
includes, but is not limited to, my application information (resume, essay, etc.), year in school, major, and so on.
___
_____________________________________
___
Signature
_______________________________________
Date
3