2018-2019Student Scholarship Application

2018-2019Student Scholarship Application

2018-2019Student Scholarship Application

GALA ND/SMC, the Gay and Lesbian Alumni/ae Association of Notre Dame and Saint Mary’s, is pleased to offer a scholarship for current Lesbians, Gay, Bisexual, Transgender, and Queer (LGBTQ) undergraduate students at the University of Notre Dame and Saint Mary’s College. The purpose of this scholarship is to provide financial assistance and support to full-time undergraduate students who identify within the LGBTQcommunity. The intention is that this scholarship will assist the recipients with reducing the financial costs incurred while pursuing their education as well as allow them to make a positive impact at Notre Dame, Saint Mary’s College, and/or the South Bend community. This scholarship is funded by the monetary contributions from GALA members and friends.

Eligibility Requirements

  • Must be enrolled as a Full-time Undergraduate Student at the University of Notre Dame or Saint Mary's College for the 2018-2019 academic year
  • Must identify within the LGBTQ Community
  • Must have a cumulative GPA of 3.0 and Above
  • Willingness to share their experience as the scholarship recipient, and the impact of receiving the scholarship, in person and/or in writing
  • Willingness to be publicly recognized as a recipient of the scholarship

While all full-time Notre Dame and Saint Mary’s students are welcome to apply, special consideration will be given to students who demonstrate financial need, have experienced marginalization on campus or in their personal life, have demonstrated leadership within the LGBTQ community, or who lack familial and social support systems.

Two qualified students will be selected and awarded a $2,500 scholarship. The scholarship is targeted for one student each from the University of Notre Dame and Saint Mary’s College, but final award is dependent on qualified applicants.

Application Submission

Applications will be acceptedfrom December 15, 2017 to March 1, 2018. Please submit both the application and the required supplemental materials no later than 5:00pm March 1, 2018. Applications that are not complete or are missing the required supplemental materials will not be considered.

In addition to the written application and supplemental material, finalists will be expected to participate in a phone interview with the selection committee. The GALA Officers and Board will review applications and notify the Scholarship Recipients no later than April 19, 2018.

Please email all application materials to:

Bryan Ricketts, GALA ND/SMC Board Member

2018-2019Student Scholarship Application

General Information

First Name: ______Last Name: ______

Preferred Name: ______Date of Birth: ______

Contact Information

Preferred E-mail: ______Phone: ______

Current Mailing Address:

______

______

Is it okay to send mail? ( ) Yes ( ) No

Permanent Mailing Address:

______

______

Is it okay to send mail? ( ) Yes ( ) No

City or town where you were raised: ______State: ______Country: ______

Sexual Orientation and Gender Identity Information

Sexual Orientation: ______Gender Identity: ______

Gender Pronouns (“she”, “he”, “hir”, “Ze”, “they” etc): ______

Winners of this scholarship may be featured in media articles (such as the Observer). Are you comfortable with friends, families, and future employers being able to find this information?: ______

Race and Ethnicity Information

The race and ethnicity information will not be used in a discriminatory manner. However, if you prefer not to answer this question, you may check “I prefer not to respond.”

___ I prefer not to respond

Please select the option that best represents the racial or ethnic background with which you most strongly identify:

( ) Alaska Native / ( ) Bi/multiracial ______/ ( ) Native Hawaiian
( ) American Indian / ( ) Black or African American / ( ) White or Caucasian
( ) Asian, Pacific Islander or Indian / ( ) Hispanic, Latino / ( ) Other

Education Information

Institution you currently attending:

( ) University of Notre Dame ( ) Saint Mary’s College

During the 2018-2019 academic year, will you be a full-time undergraduate student at the University of Notre Dame or Saint Mary’s College?

( ) Yes ( ) No

Expected date of graduation: ______Cumulative GPA: ______

Please provide your current major/concentration: ______

Please provide any minor programs of study: ______

Are you a first generation college student? ( ) Yes ( ) No

Do you currently receive any financial aid or scholarships from the college/university or from outside sources? ( ) Yes ( ) No

If yes, please list:

ScholarshipAmount of Scholarship

______

______

Do you currently receive any financial support from your family? ( ) Yes ( ) No

If yes, please describe: ______

Do you fear that if your family or other sources of financial support learned your sexual orientation or gender identity, you would lose financial support? ( ) Yes ( ) No

Please provide us with any addition information that you would like us to know about your financial situation:

______

______

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______

Current and Past Extracurricular Activities

List any LGBTQ specific Extracurricular Activities during college and/or high school:

Dates Activity Position Held

______

______

______

List all additional Extracurricular Activities, Community Service Activities, and/or Activism during college and/or high school:

Dates Activity Position Held

______

______

______

______

List any honors or awards you have received during college and/or high school:

Dates Activity Position Held

______

______

______

Essay Questions:

How,and in what ways,do you feel you would benefit from this scholarship?

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What do you feel are the biggest issues facing the University of Notre Dame and Saint Mary’s College LGBTQ communities?

______

______

______

______

______

______

______

Is there any additional information that you would like us to know?

______

______

______

The recipient of this scholarship will be responsible for sharing their experience as the scholarship recipient, and the impact of receiving the scholarship, in person and/or in writing

Are you willing to share your experience either in writing, via video and/or in person? ( ) Yes ( ) No

Disclosure and Publicity of Scholarship

If selected as a recipient of this scholarship, you would be required to sign a release of information giving GALA consent to use your name and photograph on the GALA website, in newsletters, and on social networking sites. You also agree to participate in promotional material such as video, website content and/or hardcopy and release your image in such material to GALA for our use. This requirement is in place so that we may continue to raise funds for this scholarship by soliciting donations from GALA members. This requirement is also in place so that we may provide evidence to funders and grant entities regarding the use of monetary contributions.

My signature below hereby affirms that the information that I have supplied above is true and accurate to the best of my knowledge. I understand that my application does not guarantee that I will be selected to receive this scholarship. I also understand that if I am selected as a finalist, I must submit proof of registration for the 2018-2019 academic year and my academic transcript, no later than August 1st, 2018 to receive the scholarship.

Applicant Signature ______Date ______

Required Supplemental Materials

Letters of Recommendation

Please provide twoletters of recommendation from professional referenceswho can speak to your leadership abilities, academic achievements, campus involvement, and/or financial need. A professional reference can include: a professor, college or university staff member, a mentor, member of the clergy, or a previous supervisor. Please do not provide letters from a family member, friend, or partner.