Name * First Last Email * Date of Birth * Street Address * City, State, Zip Code * Phone * WHEN DID YOU BEGIN ATTENDING CLASSES AT YOUR COLLEGE/UNIVERSITY/SCHOOL? * NUMBER OF CREDITS COMPLETED: * CUMULATIVE TRANSFERABLE GPA: AT WHICH ACCREDITED INSTITUTION DO YOU INTEND TO ENROLL? * WHAT IS YOUR PROPOSED MAJOR? * LIST ORGANIZATIONS, CLUBS AND EXTRA-CURRICULAR ACTIVITIES IN WHICH YOU HAVE BEEN ACTIVE: * LIST COMMUNITY AND VOLUNTEER SERVICE: * WHAT COLLEGE, COMMUNITY, AND HIGH SCHOOL AWARDS OR COMMENDATIONS HAVE YOU RECEIVED? * Please write about what is important to you, your goals, and the ways in which they are reflected in your accomplishments. Specifically give information about yourself, your family and background, your current activities, interests, employment, educational achievement and goals, special needs, financial circumstances, etc. This information will help the Scholarship Committee to be more completely informed about you. Please write about your plans for the future. Discuss your interest in your intended major, explain how your interest in the field developed and describe any related work or volunteer experience.