SCHOLARSHIP APPLICATION FORM
Application Deadline: April 1st, 2010
Supported by MSU SCHOLARSHIP BBQ
Scholarships will be awarded for the Fall 2010 Semester unless otherwise specified
Check the scholarship(s) for which you are applying:
_____ Maverick Momentum Undergraduate Scholarship
_____ Maverick Momentum Graduate Scholarship
_____ Maverick Momentum Study Abroad Scholarship (Fall or Spring)
_____ Maverick Momentum International Student Scholarship
Name: ________________________________
Date of Application: ___________________
Tech ID: ______________________________
Phone #(s): __________________________
Email:
Campus Mailing Address: ________________________________________________________
_______________________________________________________
Declared Major: ______________________
Declared Minor: ______________________
When do you expect to graduate? _________________________________________________
Overall GPA: ___________ (attach unofficial transcript from Campus Hub)
Full-Time Student: ___Yes ___No
Attach 500 word essay describing your leadership in the classroom, involvement in
extracurricular activities and community engagement, and work you do to support your studies.
The essay should include plans after graduation and why you believe you deserve the award.
Include one reference letter from a work/volunteer supervisor or person familiar with your
campus and/or community service. Kearney International Center employees are not eligible to
write reference letters.
If selected as a scholarship recipient, I consent to the use of my photo in college publications
including the website and will attend the MSU Scholarship BBQ on Thursday, April 22rd to be
recognized for my award.
Signature: _______________________________
Date: _____________________________