FALL SEMESTER 2013

“AL”AND MAXINE ROBERTSON MEMORIAL SCHOLARSHIP

In memory of his work on behalf of the University of Alaska and the University Board of Regents, a scholarship is awarded each year to a University of Alaska student in the name of Al Robertson, after whom the RobertsonBuilding on the UAS Ketchikan campus is named.

To be awarded this scholarship, the recipient must:

1)Register forfall semester classes at the University of Alaska full-time (at least 12 credits);

2)Apply for admission to a UA campus during senior year at Ketchikan High School;

3)Have earned at least a 2.5 high school GPA and be in good standing;

4)Include a personal essay addressing educational goals, career goals, community

involvement, and leadership roles;

5) Demonstrate financial need.

Deadline for Application is Monday, April 29, 2013

If you completed a University of Alaska Foundation Scholarship Application and you meet the criteria listed above, your application will be automatically forwarded to the scholarship committee for this award and you will not need to complete this application.

“Al” and Maxine Robertson

Memorial Scholarship

APPLICATION FORM

Personal Information

Name: ______SSN: ______

Mailing address: ______

Telephone: ______E-mail: ______

Citizenship:  US  Other: ______Alaskaresident:  No  Yes, since (year) ______

Sex:  Male  Female Place of birth: ______Date of birth: ______

citystate

High school graduation date: ______High school location: ______

city state

College Plans

Have you taken any college courses:  No  Yes If yes, please list the course(s) taken below:

______

CourseSchoolGrade

______

CourseSchoolGrade

______

CourseSchoolGrade

I plan to attend: University of Alaska Southeast ( JuneauKetchikan Sitka)

University of AlaskaAnchorageUniversity of AlaskaFairbanks

Semester(s) and year you will attend the University of Alaska:  Fall _____  Spring _____  Summer _____

Enrollment status:  Full time (12 or more credits/term) At least half time (6 or more credits/term)

Do you plan to live in Alaska after graduation?  No  YesExpected graduation date: ______

Do you plan to work while in college?  No  Yes, number of years: ______

College Major: ______Minor: ______

Essay

Describe your educational and career goals, your plans and time frame for meeting these goals, leadership roles, your involvement in extracurricular/community activities and your plans for utilizing your education after you receive your degree. This essay is very important. A subjective review of your essay is a significant part of the evaluation.

List activities in which you have participated in your high school (such as publications, intramural sports, music, art, student government and clubs, etc.):

High School Activities / Dates Participated / Offices Held / Special Awards/Honors

List community activities in which you have participated without pay (such as volunteer work, church work, crisis hot lines, peer groups, hobbies, Park & Recreation sports, community chorus, hobbies, athletics, etc.):

Kind of Work / Agency or Organization / Dates of Participation / Hours/Week / Special Awards/Honors

List jobs (including summer employment) you have held in the past two years:

Job & Kind of Work / Employer / Dates of Work / Hours/Week

Other activities and employment that you feel are important should be included in your personal essay.

I certify that the information I have provided on this application is true and correct to the best of my knowledge. I authorize the Office of the Registrar to release my academic information and the Office of Financial Aid to release my financial information to the Scholarship Committee and other third parties for the purposes of scholarship consideration. I give permission for the University of Alaskaor the UA Foundation to release information about myself and the name and amount of the scholarship if I am awarded a scholarship based on this application.

Date:______Sign:______