University of New Mexico(UNM)

2013-2014School of Engineering (SOE) General Scholarships’ Application

Please type OR print legibly, and try to fill out all sections

NOTE: If you are using a computer to fill out this form, press TAB after each entry

Personal Information

UNM ID No: / Birth City, State:
Name: / First / M.I. / Last:

Mailing Address (Award notification will be sent via e-mail or mail to the following address):

Number & Street: / Apt. #
City: / State: / Zip Code: / Phone: / ()
E-mail: / Cell Phone: / ()

Are you a NM Resident? Yes No

For how long?

Are you a Non-Resident paying resident tuition: Yes No Are you a ROTC student?Yes No

Name of High School you graduated from:
High School Location (City & State):

During High School, were you a NM MESA participant? Yes No

Are you enrolled in a federally recognized American Indian Tribe: Yes No

If Yes, please provide Tribe’s full name: / Tribal Enrollment or Census #:

The following information is needed for internal tracking and processing only:

U.S. Citizen Permanent Resident National International Student (include I-20)

Academic Information

Have you been admitted in the UNM School of Engineering? Yes No

Note: In order to be eligible for these scholarships you must have been admitted in the UNMSchool of Engineering.

Declared/Intended Major (s): / Minor:
Area of Concentration: / e.g., Structures, Biomedical Engineering, Material Science, etc.

Will you be a full time student during: Fall 2013? Yes No Spring 2014?Yes No

Year in School during the Fall 2013:

Freshman Sophomore Junior Senior Master’s PhD

Year in School during the Spring 2014:

Freshman Sophomore Junior Senior Master’s PhD

Do you plan to study abroad during 2013-2014? Yes No If yes, semester? Country?

Do you plan to do an internship or co-op during 2013-2014?Yes No

If yes: Paid Unpaid Semester? Where?

Expected Graduation Date (MM/YYYY): / /

Are you a new Transfer student recently admitted in the UNM School of Engineering? Yes No

If Yes, please enclose a copy of your most recent unofficial transcript and complete the following transferring school information:

School Name:
City & State:
Major: / Years/Terms attended:

Financial Information

Do you plan to work during: Fall 2013? Yes No Spring 2014?Yes No

Number of work hours/week: Employer:

Are you a student: Living with Parent(s)? Living On-Campus? Living Off-Campus?

Total Cost of Attendance/Budget for 2013-2014(Tuition, Room/Board, Books, etc.): $

Distribute approximate amounts of your Cost of Attendance (total School expenses) paid through:

Personal Funds $ Spouse’s support $Parental Support $ GI Bill $

Scholarships Total $ Loans $Graduate Assistantship $ Other Resources: $

Have you processed a 2013-2014 FAFSA (Free Application for Federal Student Aid)? Yes No

Although NOT REQUIRED for these scholarships, if you would like to be considered forneed-based scholarships,students who are US Citizens, Nationals or Permanent Residents mustsubmit a FAFSA application.

You could apply for FAFSA online at: . UNM’s federal aid school code is 002663.

Certification and Release

I, THE UNDERSIGNED, HEREBY CERTIFY THAT THE ABOVE STATED AND ATTACHED INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. I AUTHORIZE THE UNMSCHOOL OF ENGINEERING PERSONNEL TO REQUEST, RECEIVE, AND RELEASE INFORMATION CONCERNING MY ACADEMIC AND FINANCIAL STATUS TO/FROM UNM RECORDS, FINANCIAL AID OFFICE, SCHOOL OF ENGINEERINGACADEMIC DEPARTMENTS, AND/OR SCHOLARSHIP DONOR(S).

STUDENT’S NAME (Please print full name)
STUDENT’S SIGNATURE: / DATE:

NOTE: Please sign the application and attach all of the required documentation indicated in the application guidelines’ checklist.

Application packages must be sent OR hand-deliveredby the postmark deadline of June 1stDIRECTLY to the following address:

MAILING ADDRESS:PHYSICAL ADDRESS (if hand-delivering):

SOE ScholarshipsSOE Scholarships

MSC 01 1145Engineering Student Services Office

1 University of New MexicoCentennialEngineeringCenter, Room 2080

Albuquerque, NM87131-0001University of New Mexico – Main Campus

(Retain a copy of the application package for your records)

Current H.S. Seniors: Must complete theSOE Incoming Freshman Scholarship Application.

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