Scholarship Application Form

International Cultural Studies Department

2006 – 2007 Academic Year

 

 

Personal Information                                                                                                                               

Name:                                                                                                  BYUH ID#:                                         

Home Address:                                                                                                                                                            

Home Phone #:                                                                         Email:                                                                          

Academic Information                                                                                                                              

Expected date of graduation:                                          Are you planning on graduating from BYUH?     Y          N

                                                                                                Month                     Year

If you are a current student, have you attached your Major Academic Plan (MAP)?                                 Y          N

Current Cumulative GPA:                                  Major:                                       All courses:                              

By the end of this current semester, applicant will have completed (circle all that apply):

High School                1st year of college                    2nd year of college                  3rd year of college

Are you applying for a scholarship in a second major?                                                                             Y          N

Will you be receiving a University Scholarship Award?                                                                            Y          N

Former Education Information                                                                                                              

If incoming freshman, High School attended:                                                                                                      

                                                                                                                                                                        Name of High School                                                            Location

  • High School Cumulative GPA:                                                                                                               

If college transfer, former College/University attended:                                                                                       

                                                                                                                                                                        Name of College/University                                                 Location

  • Cumulative GPA at former College/University:                                                                                       

Courses in Major                                                                                                                                       

List courses completed in your major to date with grades.

Course                                                  Grade               Course                                                  Grade

                                                                                                                                                           

                                                                                                                                                           

                                                                                                                                                           

                                                                                                                                                           

List major courses in which you are currently registered for this and next semester/term.

                                                                                                                                                                       

                                                                                                                                                                       

                                                                                                                                                                       

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Curriculum Vitae & Statement                                                                                                              

Extracurricular Activities

List all organizations or activities participated in and relevant to the ICS Major:

 

 

 

 

Honors

List all honors & awards:

 

 

 

 

 

Personal Statement

Indicate your interest in the ICS Major:

 

 

 

 

 

 

 

 

Please list any other information that you think is relevant for the ICS Department Scholarship committee to consider.

 

 

 

 

Map Requirement                                                                                                                                      

Current and former students are required to attach a Major Academic Plan (MAP) that has been signed by their Academic Advisor.  This application is incomplete without an attached MAP.

Certification                                                                                                                                                           

I certify that the information on this form and all attached documentation is true and complete to the best of my knowledge.  I waive my rights to the Family Education Rights and Privacy Act (FERPA) regarding this application and supporting documents for the purposes of selection of recipients and for providing recipient information to the donors of this scholarship.

                                                                                                                                                                                               

Signature of applicant                                                                                                       Date