Midwestern State University West College of Education

MIDWESTERN STATE UNIVERSITY – WEST COLLEGE OF EDUCATION

West Foundation / Wichita Falls ISD Scholarship Application

Criteria: 1) pursuing a master’s degree at MSU in either education or current teaching field

2) currently employed as a professional educator by WFISD

3) unconditionally accepted into graduate program

Name: ______ID #: M______

Telephone: Home: ______Work:______

Email: ______Fax: ______

Address: ______

______

Number of years employed by WFISD: ______Current Campus:______

Current teaching assignment:

Institution conferring undergraduate degree:

Other universities attended:

Teaching fields:

Undergraduate GPA: Year of Graduation:

GRE Verbal score: ______GRE Quantitative score: ______

GRE Analytical score: ______GRE Total score: ______

MAT score: ______ADMISSION INDEX: ______

Admission to Graduate School status: Unconditional Conditional Unknown

Admission to West College of Education status: ____ Without Conditions ____ With Conditions

____ Special Student ____ Unknown

Intended Major:

Graduate Hours completed: ______Graduate GPA: ______

The application is for the ______semester.

I plan to enroll in ______graduate hours for the ______semester.

BOTH SIDES OF APPLICATION MUST BE FILLED OUT TO BE CONSIDERED FOR AWARD

OFFICE USE ONLY:

Date Received: ______New Application: ______Renewal Application:______

GPA ______Hours enrolled ______

Scholarship Amount Awarded: ______

Student’s Relationship to MSU Board of Regents Members

State law requires that each student identify any relation to a current Board of Regent member. A student who is related to a current member of the governing board of that institution is prohibited from receiving scholarships unless the scholarship is awarded exclusively based on academic merit or is an athletic scholarship. It is a Class B misdemeanor to file a false statement.

Please review a list of current Midwestern State University Board of Regent members at http://welcome.mwsu.edu/president/regents.asp and then select the most appropriate answer below indicating your relation to any of the Board of Regent members.

_____Not Relate to a Regent

_____Regent’s mother, father, daughter, son, brother, sister, grandparent or grandchild

_____Regent’s great-grandchild, uncle, aunt, nephew, or niece

_____Regent’s spouse; spouse’s child; spouse’s mother or father; child’s spouse; or parent’s spouse

_____Regent’s spouse’s brother or sister; spouse’s grandparent; spouse’s grandchild; brother or sister’s spouse; grandparent’s spouse; or grandchild’s spouse

Student’s name (printed) ______

Student’s signature ______

Date ______