Application

BRIGHAM YOUNG UNIVERSITY - HAWAII Division of Exercise and Sport Science SCHOLARSHIP/FINANCIAL AWARD APPLICATION [Scholarships]
Name
Address Telephone
Number of Semesters at BYU-Hawaii Year in School
Grade Point Average When do you plan to graduate
I am applying for:		Division Scholarship/Financial Award
		Rhonda Au Scholarship (Currently not available)
Major Field of Study:		Exercise Science
		Health and Wellness
		Physical Education (Teaching Certification)
		Other
Professional Service and Leadership Community Involvement: (list all volunteer work, affiliation with professional organizations, church organizations)
Extracurricular School Activities: (offices held, campus work)
Awards, Honors, or Special Achievement Earned in School of Work
Faculty References: List 3 teachers familiar with you and your work.

Name

Address

Position

Phone

Note: If the faculty member is not from BYU-Hawaii, enclose a stamped, addressed envelope with the recommendation form. If the faculty member is at BYU-Hawaii, enclose an addressed envelope along with the reference form.

Financial Status
1. Do you receive any financial assistance now? YES NO
(Loans, scholarships, stipends) Please list.

2. Do you plan to be employed during the school year?               YES                       NO
     Where?
    If so, what will be your estimated gross monthly income?

If married, does your spouse receive financial assistance? YES NO

If so, please list sourse and amount.

List any other source of monthly income?

ESTIMATED TOTAL MONTHLY INCOME

I certify that the information I have provided is true and correct. I understand that if I drop out of school during the semester, I will notify the award committee and that a prorated partial return of the scholarship award will be expected. I understand that the award given to me will be in the form of BYU-Hawaii vouchers and will be used to cover educational expenses only.

Date Applicant's Signature