2014-2015
Scholarship Application Deadline: March 31, 2014
ABOUT YOU:
Full Name Male Female
Street Address City
State ZIP Phone Telephone
High School/ HSED/GED Year Graduated/HSED/GED Obtained HS GPA
Other Colleges & Dates Attended
(If applicable)
College GPA College Major Date of Birth
ADDITIONAL INFORMATION
New freshman at UW-Rock County Full-Time Part-Time
Transferring to UW-Rock County Full-Time Part-Time
Continuing Student at UW-Rock County Full-Time Part-Time
Transferring to 4-year University in Fall Semester School Name (Certain scholarships can be used at your transfer school.)
REQUIRED WRITTEN ATTACHMENTS TO APPLICATION
ESSAY:
Write a brief essay of approximately 250 words or less (one type-written page).
Indicate your educational interests and goals and how a scholarship will impact those goals. Use specific examples that clearly illustrate how your education and life experiences helped you develop these goals.
AWARDS AND ACTIVITIES:
On a separate sheet of paper, list the high school, college, employment and/or community activities in which you have made a significant contribution or received an award. Please state the activity, briefly describe and date your contributions/awards. Listing volunteer hours is HIGHLY suggested. Explain why your involvement in these activities was valuable to the organization and community.
LETTERS OF Recommendation: Recommendation forms provided at end of application.
Two letters of recommendation must be submitted (Please list reference name and title below).
1.
2.
COMPLETE: ADMISSIONS APPLICATION FOR UW-ROCK COUNTY for the fall semester
(If you have not already done so)
GENERAL SCHOLARSHIP APPLICATION FORM (pg: 1) Please review the 2014-2015 Scholarship List for scholarships that follow the general scholarship guidelines.
The following scholarships have additional requirements.
Check the box of each scholarship you are applying for and provide required documentation. You must meet each additional requirement listed to be eligible for each scholarship.
Partnership For Parents: ____Single Parent ____Enrolled for minimum 6 credits
____2.5 GPA Essay: Provide a short description of how this assistance will help you succeed academically.
Albrecht : ____Proof of qualification as an individual with a disability
Lars Christian: ____Critical acclaim for an artistic: performance, painting
or an outstanding performance in affairs or competitions
____On Dean’s List
H.E.A.T.: ____Homeless Verification or Certification
Alliant Energy: Preference given to minorities or under-represented groups.
Ethnicity or Group ______
I authorize the UW-Rock County Foundation Scholarship Committee to share the information on this application and admission packet with those individuals and agents participating in the scholarship granting process and obtain verification of information from aforementioned individuals and agents. I certify that the information provided is true, accurate and complete to the best of my knowledge.
Applicant’s Signature ______Date______
The University of Wisconsin-Rock County Foundation, Inc., does not discriminate on the basis of age, race, religion, creed, color, handicap, gender, sexual orientation, developmental disability, national origin, ancestry, marital status, arrest record or conviction of record in employment or in its scholarship program and activities as required by state and federal laws and regulations.
March 31, 2014, is the deadline for receipt of applications, transcripts and references.
Mail Applications to:
UW-Rock County Foundation
c/o Cindy Zaharias
University of Wisconsin - Rock County
2909 Kellogg Avenue Janesville, WI 53546
University of Wisconsin-Rock County Foundation
Scholarship Program Letter of Recommendation
______is an applicant for scholarship at the University of Wisconsin–Rock County. These scholarships will be awarded primarily on the basis of academic achievement and potential.
Please use the back of this form or attach a separate page to evaluate the student. It is helpful for the scholarship committee if you include the student’s past and present academic achievements, future scholastic potential, and his or her leadership and achievement in campus and community activities.
______
Signature Title
______
Business Address Business Telephone (with area code) Date
Recommendations must be received by March 31, 2014.
Mail To: UW–Rock County Foundation
c/o Cindy Zaharias
University of Wisconsin Rock County
2909 Kellogg Avenue
Janesville, WI 53546
The Freedom of Information Act requires that this reference be made available to applicant upon request.
Optional Student Waiver: I waive my right to review this Letter of Reference.
______
Student Signature Date
2909 Kellogg Avenue, Janesville, WI 53546 Phone (608) 758-6565 Ext 390 email
University of Wisconsin-Rock County Foundation
Scholarship Program Letter of Recommendation
______is an applicant for scholarship at the University of Wisconsin–Rock County. These scholarships will be awarded primarily on the basis of academic achievement and potential.
Please use the back of this form or attach a separate page to evaluate the student. It is helpful for the scholarship committee if you include the student’s past and present academic achievements, future scholastic potential, and his or her leadership and achievement in campus and community activities.
______
Signature Title
______
Business Address Business Telephone (with area code) Date
Recommendations must be received by March 31, 2014.
Mail To: UW–Rock County Foundation
c/o Cindy Zaharias
University of Wisconsin Rock County
2909 Kellogg Avenue
Janesville, WI 53546
The Freedom of Information Act requires that this reference be made available to applicant upon request.
Optional Student Waiver: I waive my right to review this Letter of Reference.
______
Student Signature Date
2909 Kellogg Avenue, Janesville, WI 53546 Phone (608) 758-6565 Ext 390 email
1