ScholarshipApp by cuiliqing


									            Professional Education Program                                            1. Last Name, First Name, M.I.
            Scholarship Application

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
                                  Student ID
                          Teaching Major(s)
                          Teaching Minor(s)
                               Local Address

                   Preferred phone number
                              Home Address

   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
                              Cumulative GPA
   (#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
                             offices held

                         Volunteer Activities

             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)

                                                                                                                                  5. Submission
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
                              sealed/signed envelope).
                             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.

Revised 1/4/12
                                        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:
                                                                                            NAME                   AGE

                WI                          Non-
              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…

                   ________________________________________                   _____________________
                         Signature                                                 Date

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