2017-2018 SCHOLARSHIP APPLICATION

Instructions:

Complete and return this application along with a one-page essay describing how the scholarship would benefit you and your community.

Complete the Free Application for Federal Student Aid (FAFSA) for the appropriate academic year listing ColumbusStateUniversity (school code 001561). The Columbus State University Financial Aid Office must receive the results of the FAFSA by the scholarship deadline. Please allow 1 to 2 weeks for processing of the FAFSA by the Department of Education.

Be accepted as a regularly admitted student to ColumbusStateUniversity.

Submit all of the above to the Columbus State University Financial Aid Office, 4225 University Ave., Columbus, GA 31907-5645by the scholarship deadline – January 31st, 2017

PLEASE TYPE INFORMATION

1. Full Name:

2. Street Address:City: State:Zip:

3. Social Security Number: Date of Birth:

4. State of Residence:County of Residence:

5. Telephone Number (Home) (Work)

6. CSU Email Address:

7. Major: Grade Level:

8. Place of Employment:

9. Name of high school you graduated from: City: State:

10. List extracurricular activities of the last three years:

Activity / Date / Description

11.List honors received while in high school or college:

Name of Honor / Date / Description

Please check the scholarships for which you would like to apply and answer any corresponding questions. This application will only be considered for the scholarships checked.

The Claude Allen Shumate, Jr., & Claude Allen Shumate III Memorial Scholarship

Cougar Village Scholarship

Do you reside in Cougar Village apartment complex? Yes No

Duke & The Doctor Scholarship

Are you studying in the Turner College of Business, at least 30 years old, and working

at least 15 hours per week? Yes No

Kennon, Parker, Duncan & Key Scholarship / Only available to juniors and seniors.

M. Kyle and CarraBattiato Floyd Scholarship

Are you a high school graduate of Hardaway High or Troup County High? Yes No

Mae Johnson Scholarship

Do you have relatives employed at ColumbusStateUniversity? Yes No

If so, give name(s)?

The Annie and Emmitt Scott Leadership Scholarship

Are you a graduate of Manchester High School? Yes No

The Florence Jean and C. Alex Sears, Jr. Scholarship Endowment

Are you or have you ever been a participant of Girls Inc.? Yes No

If yes, please attach a statement of participation in Girls Inc.

The Judy S. & Morton A. Harris Scholarship

Are you a high school graduate of the Muscogee County School District? Yes No

Are you a graduate of Columbus High? Yes No

The M. Troy and Gloria S. Woods Scholarship

Are you a resident of Stewart County? Yes No?

Walter and Sally Lunsford Scholarship

Are you a single-working Mother attending at least half-time? Yes No

ESSAY

Please attach an at least 500 word typed essay expressing how this scholarship will benefit you and your community.

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Printed SignatureDate

PLEASE REFER TO THE WEBSITE, FOR A CURRENT LISTING OF ALL SCHOLARSHIPS AND DEADLINE DATES

(2) Rev 10/28/16