2014‐2015
UALR
COLLEGEOFEDUCATION
PRIVATESCHOLARSHIPAPPLICATIONNEWSTUDENTSCHOLARSHIP Fall 2014
Instructions:Pleasecompleteallsectionsthatapplytoyouandrespondtoeachsectionasaccuratelyaspossible. Incomplete applicationswill not be considered.
SECTIONI: GENERALINFORMATION
Name:
Address:
Email Address:
HomePhone:
Work/Cell Phone: _
ArkansasResident?YESNO
EducationalInformation:
(Listhighschoolandallcollegesattended)
School NameCityand StateDatesAttended
High School:
College Attended: _ / __ / _
_ / _
Current ProposedStudentClassification:TransferContinuing UALR UndergraduateGraduate/Doctoral
College of EducationMajororIntendedMajor:
PlannedEnrollmentStatusforFall2014- 3 Hours6 HoursMore than6 Hours
Are you currentlyreceivinga scholarshipfrom UALR?YESNO If so,pleasenamescholarship and amount
SECTION II:STATEMENTOFSTUDENT’SGOALSAND NEEDS
Give a briefstatementconcerningyourplanforstudyaswell asyourextracurricularactivities, honors, achievements, andleadershippositions.Whatdoesthe scholarshipcommittee needto knowabout your backgroundandinfluencesfor youracademicpursuits? How will thispossiblefundingimpact your course of study? (Usethespaceprovided,orattachaseparatesheetifneeded)
SECTION III:CERTIFICATION
I certifythatallinformationandstatementsprovided byme onthisapplicationare true to the bestof my knowledge. Donorsoragenciesoutside UALRoccasionallyrequestinformationcontainedonthisapplication. I permitthe release of educational, personal, andfinancialinformationto outside agenciesinorderto beconsidered for scholarships.
Signature:
Date
UALRNondiscrimination Policy
TheUniversityof Arkansasat Little Rockdoesnotdiscriminate inadmissions,treatmentof students, employment, orprogramsonthe basisof sex, handicap, age, race,national origin, color,orreligionas specified byTitle IXof the EducationAmendmentof1972, Rehabilitation Actof 1973, andotherfederal lawsandregulations. Inquiries concerningthe applicationof anyof the federal lawsorregulationsmay be referredto the HumanRelations Officer,Universityof Arkansasat Little Rock, 569‐8675.
Pleasesubmitapplication by July 15th,2014to:
Attn: Lisa Palacios
UALRCollege ofEducation, DeansOffice