Professional Education Program 1. Last Name, First Name, M.I.
Directions: 1. Complete the application below. 2. Save and Print your completed application. 3. Sign your application.
4. Return your completed application to: 470 College of Professional Studies by 4:30 pm on Feb 10, 2012.
2. Personal Information
Last Name, First Name, Middle Initial
Preferred phone number
Expected Academic Status for Fall 2012
(add credits earned + credits in progress – Freshman (29 or fewer cr) Sophomore (30-59 cr)
#3 under “Additional University Graduation Junior (60-89 cr) Senior (90+ cr) Grad
Requirements” on DPR)
Currently accepted to the Professional Education Program.
Professional Education Program Admission
Not currently admitted - applying to the Program this semester (Spring ’12).
Not currently admitted - will not apply to the Program this semester.
Projected semester of student teaching
(#5 under “Additional University Graduation
Requirements” on DPR)
Are you a first-generation college student? Yes No
3. Involvement & Employment Information
Professional Memberships & Student
Organization Involvement. Indicate any
Recent Employment Activities
List any scholarships or financial aid that
you receive for this year (2011-2012),
please list the name(s) and amount(s)
4. Scholarship Information
Review the scholarship descriptions and criteria here.
After doing so, indicate each scholarship for which you qualify.**
**Students applying to the Professional Education Program in Spring 2012 are eligible to apply for scholarships requiring admission to the
Program. The SOE Awards Committee will verify admission status prior to awarding scholarships.
Baird Falkinham Hayes Lewis Petersen SOE Alumni
Bannach Fierek Hegg Maher* Proefrock Thoyre*
Belongia Gach Jensen Martini Radke Vance
Berndt Garr Dawley* KDP McCaig Ravey Van Dresser
Berndt-Harju Gordon Kapter/Bernd Neale Rohloff, Roesler & Wolter Wood
Daffinson Habeck Lea Memorial Nelson Rossmiller Yulga
Dickmann Haferbecker* Okray Samter
Eskritt* Pearson Sheahan
Scholarships marked with an asterisks (*) above give preference to “non-traditional” students.
UWSP defines “non-traditional” students as students who meet at least one of the criteria below:
If you are applying for any of these scholarships, please indicate how you identify as a “non-traditional” student.
Check all that apply.
24 years of age or older Married Delayed enrollment in post-secondary education
Veteran status Divorced Legal dependents (children, spouse, parents)
Please attach the following before submitting your application.
Copy of your Spring 2012 class schedule
SOE Scholarship Reference (one confidential reference must be attached in a
Newly printed Degree Progress Report (for Hegg Scholarship applicants only)
Lesson Plan (for Neale Scholarship applicants only)
Early Childhood Education Essay (for Petersen Scholarship applicants only)
Eskritt Memorial Scholarship Application (for Eskritt Scholarship applicants only)
For scholarship application purposes, I release the above information, including academic records, reference forms and
financial need status, to be shared with the School of Education Awards Committee and scholarship donors. I understand
that there may be more qualified applicants than there are scholarships, and submitting an application does not
guarantee a scholarship award.
Student Signature Date
Scholarship applicants will be required to complete an essay, which will be written in-person. Essay
times/dates are posted online. Students should plan on signing up for an essay writing time when they
submit their scholarship application. Students who qualify for accommodations through Disability Services
should notify Linda Mirr at the time they submit a scholarship application.
Completed application packets must be submitted to 470 College of Professional Studies by
4:30pm on February 10, 2012. Late application packets will not be accepted.
Additional Application for
Lenice Christine Merrill Eskritt Memorial Scholarship
Application Deadline: February 10, 2012 by 4:30 p.m.
**This additional application is only required for students applying for the Eskritt Memorial Scholarship.
* Undergraduate or Graduate Student
* At Least Four Semesters Completed
* 3.0 or better cumulative grade point
* Dependent children living with you
* Full or Part-time Student
* Working toward a degree with a declared major
Name (please print or type) Email
Street Address Area Code & Telephone Number
City State Zip Code
PLEASE LIST NAMES AND AGES OF CHILDREN:
Resident Resident Undergraduate Graduate
Total Credits Earned Cumulative GPA # Credits This Semester
Major Minor Expected Graduation Year
Attach separate sheets for the following:
Brief Personal History – Please discuss your most recent background, why you are in school, how
did you select your field of study/major, what are your goals, etc.
The committee should select me as the Scholarship recipient because…