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Supplement A

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					                          Morehead State University (MSU)
                      Computer Science and Mathematics (CSAM)
                               Scholarship Application
                             for Current MSU Students

                                         Eligibility Requirements
1. Must be a U.S. citizen, national, refugee alien, or permanent resident alien at the time of application
2. Must be a full-time student in the MSU computer science or mathematics program during the time
   period for which the scholarship is awarded
3. Must have filled out and submitted to MSU the Free Application for Federal Student Aid (FAFSA)
   form and must qualify for financial need in accordance with the U.S. Department of Education
   regulations
4. Minimum GPA of 2.75 preferred for students who will be a freshman or sophomore during the time
   period for which the scholarship is awarded
5. Minimum GPA of 3.0 preferred for students who will be a junior or senior during the time period for
   which the scholarship is awarded



   PLEASE TYPE OR PRINT


   I. Student Information

   Name:________________________________________________________________________
         (Last)                      (First)                        (Middle)

   Social Security Number: ________________________             Date: __________________________

   Legal Status (check one): U.S. Citizen _____ U.S. National _____          Refugee Alien _____
                             Permanent Resident Alien _____

   Major or Area of Concentration: ____________________________________________________

   Ethnicity (Optional): _______________________           Gender (Optional): ___________________

   Current Address:
   ______________________________________________________________________________
   (Street)
   ______________________________________________________________________________
   (City)                           (State)                   (Zip)

   Email Address: _________________________________________________________________

   Current Phone: __________________________

   Total Number of Hours Completed: __________

   Overall MSU Grade Point Average: _________ on a 4.0-point scale.




                                               (over, please)
                      Morehead State University (MSU)
                  Computer Science and Mathematics (CSAM)
                           Scholarship Application
                    for Current MSU Students (continued)


Career Goals: __________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________


List Extra-Curricular Activities (include offices held and number of years of participation):

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________


Describe Work Experience (indicate length of employment):

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

                   (If extra space is required, add an attachment for the above.)

II. Required Supplementary Materials.

    1. Ask a total of three (3) faculty members or administrators to complete a letter of
       recommendation and mail it to the address printed on the bottom of the form.
    2. Submit an official copy of your current MSU transcript.
    3. Submit a statement giving a thorough justification of your financial need and explaining
       how your financial situation affects your academic progress.

III. Notes.

You may be contacted for a personal interview.
You may include with this application any other evidence of academic achievement or potential.
If you have questions regarding this form, please call 606-783-2930.

Submit this form to Department of Mathematics and Computer Science, UPO 701,
150 University Blvd., Morehead State University, Morehead, KY 40351-1689.


Partial support for this grant was provided by the National Science Foundation’s Computer
Science, Engineering, and Mathematics Scholarships Program under grant DUE 0324106.


                                                                                    11/17/03 version

				
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