NORTHEAST ALABAMA CHAPTER

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Application Form for

Accounting Scholarships

Fall 2016 thru Spring 2017 (Due January 29, 2016)

Completing this one application form will allow you to be considered for any of the following six accounting scholarships:

Collins-McCain Scholarship

John Collins Scholarship

Pearce, Bevill, Leesburg & Moore Scholarship

The Warren, Averett, Kimbrough & Marino, LLC Scholarship

Trathen Scholarship

Northeast Chapter of the Alabama Society of Certified Public Accountants (ASCPA)

(Important: Two scholarships are available from the ASCPA. This application only covers the one from the Northeast Chapter of the ASCPA.

There is also a scholarship from the ASCPA Educational Foundation that requires a separate application. Please ensure that you locate the separate application on the website for the Office of

Student Financial Services and consider applying for it also.)

In addition, applicants must submit a resume and statement of why you want the scholarship (25 words or less) as an attachment on a separate page. Please ensure that you submit the required attachments with this application.

Other accounting scholarships in addition to the six scholarships listed above are shown on the website for the

Office of Student Financial Services. Students are encouraged to review these other scholarships and apply for them. (See above note under bullet for the Northeast Chapter of the Alabama Society of Certified Public

Accountants)

If you have any questions or need help with the above application process, please contact:

Mr. Martin Weldon, 105 Bibb Graves Hall, (256) 782-5677, mweldon@jsu.edu

Important:

Please ensure that you complete all four pages of this application and staple it together along with the attachments in the upper left-hand corner. Return it to the JSU Scholarship Office, Office of Student

Financial Services in 105 Bibb Graves Hall by the January 29, 2016 deadline.

I. Personal Information:

Name: ____________________________________

Student Number: _________________________________ Birth Date: __________________________

Current Mailing Address: _____________________________________________

Home Address (if different): __________________________________________ E-mail: _________________

Phone Number: _____________________________

Page 1 of 4

Application Form for

Accounting Scholarships

Fall 2016 thru Spring 2017 (Due January 29, 2016)

II. Career Planing

Are you planning a Career in Accounting? Yes or No

If you are planning a career in accounting, which career track would you prefer (please check one choice)?

___ Private Industry ___ Governmental ___ Public Accounting as a CPA

____ Other (please specify):__________________________________

III. Major and Current Grade Point Averages:

Major (if other an Accounting): ___________________ Major GPA: ______________

Overall GPA: _____________ Overall GPA at JSU (if different): __________

IV. Academic Progress and Planning:

Are you currently a full-time student? Yes or No

Total hours earned as of 1/1/2016: _________ (other than institutional credit as defined in the JSU catalogue)

Total hours earned at JSU as of 1/1/2016 (if different): __________

List the Accounting courses you have completed thru Fall 2015:

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

Anticipated number of hours of enrollment at JSU in the:

(1) Fall 2016 term: _________ (2) Spring 2017 term: _____________

Expected Graduation Date: _______________________

Page 2 of 4

Application Form for

Accounting Scholarships

Fall 2016 thru Spring 2017 (Due January 29, 2016)

V. Activities and Leadership Roles in Accounting

Are you a student member of the Alabama Society of CPAs?

Are you a member of the Student Accounting Association?

If yes, please complete the following:

Officer (officer position and date):

Committee Chair (committee and date):

Yes or No

Yes or No

____________________________

____________________________

Committee Service (committee and date): ____________________________

Number of SAA meetings attended this school year: ____________________________

Other Accounting Leadership Positions, Organization Memberships, Honors, Campus Involvement and Other

Pertinent Information – (Please indicate if an organization is a JSU organization by placing a * before the name):

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

VI. Activities and Leadership Roles Outside of Accounting:

Leadership Positions, Organization Memberships, Honors, Campus Involvement and Other Pertinent

Information – (Please indicate if an organization is a JSU organization by placing a * before the name):

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

Page 3 of 4

Application Form for

Accounting Scholarships

Fall 2016 thru Spring 2017 (Due January 29, 2016)

VII. Financial Assistance

Please describe any financial assistance that you know you will be receiving during the next school year (Fall

2016 thru Spring 2017):

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

Please list any current and prior grants and/or scholarships that you have received:

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

Please list any jobs while a student providing a description including the dates worked:

_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

VIII. Signature(s)

By signing this application, you are providing your permission for the scholarship committee and appropriate personnel at JSU to view and verify any of the information provided on this application. Applicants for the

Trathen Scholarship are also agreeing to allow members of the accounting faculty to complete a confidential evaluation of your character and behavior. Ensure that you attach the items described on page 1 of this application and obtain the signature of a faculty sponsor.

Student Signature___________________________________ Date: ___________________________

Signature of Faculty Sponsor __________________________ Date: ___________________________

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